The characterization and the impact of CSF pleocytosis during blinatumomab therapy for adult acute lymphoblastic leukemia.

Autor: Ngo D; Department of Pharmacy, City of Hope, Duarte, CA, USA., Tinajero J; Department of Pharmacy, City of Hope, Duarte, CA, USA., Song JY; Department of Pathology, Division of Hematopathology, City of Hope, Duarte, CA, USA., Ma H; Department of Computational and Quantitative Medicine, Division of Health Analytics, City of Hope, Duarte, CA, USA., Quirk E; Department of Pathology, Division of Hematopathology, City of Hope, Duarte, CA, USA., Koller P; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA., Pourhassan H; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA., Agrawal V; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA., Stein AS; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA., Marcucci G; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA., Murphy L; Department of Pediatrics, City of Hope, Duarte, CA, USA., Forman SJ; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA., Pullarkat V; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA., Aldoss I; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA.
Jazyk: angličtina
Zdroj: Leukemia & lymphoma [Leuk Lymphoma] 2024 Dec; Vol. 65 (13), pp. 2016-2024. Date of Electronic Publication: 2024 Aug 18.
DOI: 10.1080/10428194.2024.2392823
Abstrakt: Reactive pleocytosis in the CSF has been observed with blinatumomab but has not been well-described. We performed a retrospective study of 88 patients who received intrathecal chemotherapy (IT) while on blinatumomab with CSF analyzed to determine if pleocytosis had an impact efficacy and safety. Blinatumomab was used for relapsed/refractory 62.5%, MRD-positive 31.8%, and consolidation in MRD-negative 5.7%. The incidence of pleocytosis in CSF was 51% and was more frequent after day 15 (55.8% vs. 18.2%, p  = 0.025). Pleocytosis did not impact CR, clearance of MRD positivity, PFS and OS rates. Lower incidence of non-CNS extramedullary relapse was seen (3.7% vs. 30.8%, p  = 0.011) with pleocytosis in CSF. Analysis of CSF by flow cytometry showed median CD4:CD8 ratio of 1.34. In conclusion, CSF pleocytosis is prevalent with blinatumomab but only demonstrated lower rates of non-CNS extramedullary relapse but no impact on CNS relapse or neurotoxicity.
Databáze: MEDLINE