Pre-transplant blinatumomab reduces MRD, time to HCT for pediatric patients with B-ALL

In this retrospective study of 15 pediatric patients age 0 to 21 years with relapsed or refractory B acute lymphoblastic leukemia (B-ALL) and persistent minimal residual disease (MRD), researchers found that pre-transplant blinatumomab reduced MRD to undetectable levels, reduced time needed to receive a transplant, and resulted in “favorable leukemia-free survival, toxicity, and overall survival.”

The median age of patients at the time of blinatumomab treatment was 9 years (range, 0.5-19), and patients had a variety of cytogenetic abnormalities.

Ten of the 15 patients were in their first remission (CR1) at the time of blinatumomab and subsequent allogeneic hematopoietic cell transplant (HCT). Fourteen of 15 patients were MRD negative following blinatumomab therapy and proceeded to HCT at a median time of 14 days (range, 1 to 35) from end of blinatumomab therapy to start of HCT preparative regimen.

One-year overall survival was 93.3%, and there was no transplant-related mortality in the first 100 days.

One patient experienced a grade 3 seizure during blinatumomab therapy; there were no other grade 3 or 4 toxicities or cytokine release syndrome events.

The authors concluded that blinatumomab was safe and effective in pediatric leukemia, successfully reduced MRD to undetectable levels in most patients (93.3%), and was tolerated without serious infection or organ toxicity.


Keating AK, et al., Blood Advances