Characterization of relapse patterns in patients with acute lymphoblastic leukemia treated with blinatumomab

Introduction Blinatumomab is a CD19/CD3 bispecific T-cell engager (BiTE) antibody that simultaneously binds CD19 on the surface of B-cells and CD3 on the surface of T-cells, resulting in tumor cell lysis. It is approved for the treatment of patients with relapsed/refractory B-cell acute lymphoblasti...

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Bibliographic Details
Published in:Journal of oncology pharmacy practice 2021-06, Vol.27 (4), p.821-826
Main Authors: Lau, Kimberly M, Saunders, Ila M, Goodman, Aaron M
Format: Article
Language:English
Subjects:
Acute lymphoblastic leukemia
Adrenal glands
Beta cells
CD19 antigen
CD3 antigen
Chemotherapy
Demography
Leukemia
Lymphatic leukemia
Lymphocytes T
Lysis
Minimal residual disease
Monoclonal antibodies
Pancreas
Parotid gland
Patients
Targeted cancer therapy
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Summary:Introduction Blinatumomab is a CD19/CD3 bispecific T-cell engager (BiTE) antibody that simultaneously binds CD19 on the surface of B-cells and CD3 on the surface of T-cells, resulting in tumor cell lysis. It is approved for the treatment of patients with relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL) and in patients with minimal residual disease after intensive induction chemotherapy. Relapse patterns after treatment with blinatumomab have not been well characterized. Methods We reviewed patients treated with blinatumomab with relapsed, refractory or minimal residual disease-positive B-ALL from 1 December 2014 to 31 December 2018 at a single academic medical center. Patient demographics, blast percentage prior to blinatumomab initiation, prior lines of therapy, blinatumomab treatment duration, sites of relapse, progression free survival, and overall survival were collected. Results A total of 20 patients were identified. Four (20%) patients developed extramedullary relapse following blinatumomab. The median time from treatment initiation to extramedullary relapse was 179 days (range 47–241). Sites of extramedullary relapse included the pancreas, adrenal gland, kidneys, liver, parotid gland, and brain. Conclusion Extramedullary relapse occurs frequently following treatment of B-ALL with blinatumomab. Further studies aimed at preventing extramedullary relapse following blinatumomab treatment are warranted.
ISSN:1078-1552
1477-092X
DOI:10.1177/1078155220934853