| Title: |
Blinatumomab for First-Line Treatment of Children and Young Persons With B-ALL |
| Authors: |
Hodder, Angus; Mishra, Avijeet K; Enshaei, Amir; Baird, Susan; Elbeshlawi, Ismail; Bonney, Denise; Clesham, Katherine; Cummins, Michelle; Vedi, Aditi; Gibson, Brenda; George, Lindsay; Ingham, Danielle; Jigoulina, Galina; Lancaster, Donna; Lindsay, Katherine; Madni, Majid; Malone, Andrea; Mitchell, Bethany; Moppett, John; Motwani, Jayashree; Moorman, Anthony V; Patrick, Katharine; Samrin, Lamia; Tewari, Sanjay; Thakur, Indu; O'Connor, David; Samarasinghe, Sujith; Vora, Ajay |
| Source: |
Journal of Clinical Oncology , 42 (8) pp. 907-914. (2024) |
| Publisher Information: |
American Society of Clinical Oncology |
| Publication Year: |
2024 |
| Collection: |
University College London: UCL Discovery |
| Description: |
PURPOSE: We tested whether blinatumomab (Blina) is effective as a toxicity-sparing alternative to first-line intensive chemotherapy in children and young persons (CYP) with B-ALL who were chemotherapy-intolerant or chemotherapy-resistant. METHODS: Data were collected for consecutive CYP (age 1-24 years) with Philadelphia chromosome-positive or Philadelphia chromosome-negative B-ALL who received Blina as first-line therapy. Blina was given as replacement for postremission intensive chemotherapy to patients with chemotherapy intolerance or resistance. Blina responders received further chemotherapy (Blin-CT) or first remission hematopoietic stem-cell transplant (Blin-HSCT) if indicated. Event-free survival (EFS) and overall survival (OS) of the Blin-CT group were compared with those of matched controls treated with standard chemotherapy in the UKALL 2003 trial. Events were defined as death, relapse, or secondary cancer. RESULTS: From February 2018 to February 2023, 105 patients were treated, of whom 85 were in the Blin-CT group and 20 were in the Blin-HSCT group. A majority of Blin-CT patients received Blina for chemotherapy intolerance (70 of 85, 82%), and the group had a higher-risk profile than unselected patients with B-ALL. Blina was well tolerated with only one patient having a grade 3/4-related toxicity event, and of the 60 patients who were minimal residual disease-positive pre-Blina, 58 of 60 (97%) responded. At a median follow-up of 22 months, the 2-year outcomes of the 80 matched Blin-CT group patients were similar to those of 192 controls (EFS, 95% [95% CI, 85 to 98] v 90% [95% CI, 65 to 93] and OS, 97% [95% CI, 86 to 99] v 94% [95% CI, 89 to 96]). Of the 20 in the HSCT group, three died because of transplant complications and two relapsed. CONCLUSION: Blina is safe and effective in first-line treatment of chemotherapy-intolerant CYP with ALL. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10181934/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10181934/1/hodder-et-al-2023-blinatumomab-for-first-line-treatment-of-children-and-young-persons-with-b-all.pdf; https://discovery.ucl.ac.uk/id/eprint/10181934/ |
| Rights: |
open |
| Accession Number: |
edsbas.3EDCE4FF |
| Database: |
BASE |