Clinical utilization of blinatumomab and inotuzumab immunotherapy in children with relapsed or refractory B‐acute lymphoblastic leukemia

Autor: Elliot Stieglitz, Cristina F. Contreras, Christine Higham, Sarah K. Tasian, Astrid Behnert, Kailyn Kim
Rok vydání: 2020
Předmět:
Male
Oncology
medicine.medical_treatment
Drug Resistance
Hematopoietic stem cell transplantation
0302 clinical medicine
blinatumomab
Antibodies
Bispecific
Antineoplastic Combined Chemotherapy Protocols
Child
6.2 Cellular and gene therapies
Cancer
Pediatric
Hematology
Prognosis
Local
Child
Preschool
6.1 Pharmaceuticals
030220 oncology & carcinogenesis
hematopoietic stem cell transplantation
Bispecific
Female
Blinatumomab
immunotherapy
medicine.drug
Adult
Pediatric Research Initiative
medicine.medical_specialty
Adolescent
Childhood Leukemia
Pediatric Cancer
Clinical Trials and Supportive Activities
Clinical Sciences
Oncology and Carcinogenesis
acute lymphoblastic leukemia
Article
Antibodies
Vaccine Related
Paediatrics and Reproductive Medicine
Young Adult
03 medical and health sciences
Rare Diseases
Refractory
Clinical Research
Precursor B-Cell Lymphoblastic Leukemia-Lymphoma
Internal medicine
medicine
Humans
Inotuzumab Ozogamicin
Oncology & Carcinogenesis
B Acute Lymphoblastic Leukemia
Preschool
Retrospective Studies
Salvage Therapy
Transplantation
Chemotherapy
business.industry
Infant
Evaluation of treatments and therapeutic interventions
Immunotherapy
Minimal residual disease
Clinical trial
Neoplasm Recurrence
Good Health and Well Being
Drug Resistance
Neoplasm
Pediatrics
Perinatology and Child Health
Neoplasm
Immunization
Neoplasm Recurrence
Local
business
inotuzumab
Follow-Up Studies
030215 immunology
Zdroj: Pediatric blood & cancer, vol 68, iss 1
Pediatr Blood Cancer
ISSN: 1545-5017
1545-5009
Popis: Background The treatment paradigm for patients with relapsed/refractory B-cell acute lymphoblastic leukemia (rrALL) has been revolutionized given recent clinical trials demonstrating remarkable success of immunotherapies and leading to drug approvals by United States and European agencies. We report experience with commercial blinatumomab and inotuzumab use at two North American pediatric oncology centers in children and adolescents/young adults with B-ALL. Procedure Patients 0-25 years old treated with the CD19 × CD3 bispecific T cell-engaging antibody blinatumomab and/or the CD22 antibody-drug conjugate inotuzumab from January 1, 2010, to June 1, 2018, were eligible. Disease status included relapsed B-ALL in second or greater relapse, primary chemotherapy-refractory B-ALL, or B-ALL complicated by severe infection precluding delivery of conventional chemotherapy. Results We identified 27 patients who received blinatumomab and/or inotuzumab outside of clinical trials during the study period. Four of the 13 patients (31%) with relapsed disease achieved minimal residual disease (MRD)-negative remission, and five patients (39%) underwent hematopoietic stem cell transplant (HSCT). In the 12 patients with primary chemorefractory B-ALL treated with immunotherapy, 11 (92%) achieved MRD-negative remission as assessed by flow cytometry; 10 patients (83%) underwent subsequent HSCT. Two patients with B-ALL in MRD-negative remission received blinatumomab due to severe infection and remained in remission after chemotherapy continuation. Conclusions Blinatumomab and inotuzumab can induce deep remissions in patients with rrALL and facilitate subsequent HSCT or other cellular therapies. Blinatumomab can also serve as an effective bridging therapy during severe infection. The optimal timing, choice of immunotherapeutic agent(s), and duration of responses require further investigation via larger-scale clinical trials.
Databáze: OpenAIRE
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