Efficacy of blinatumomab as a bridge therapy for allogeneic hematopoietic stem cell transplantation in treatment of minimal residual disease-positive B-lineage acute lymphoblastic leukemia
10.13406/j.cnki.cyxb.003939
- VernacularTitle:贝林妥欧单抗桥接异基因造血干细胞移植治疗微小残留病阳性急性B淋巴细胞白血病疗效分析
- Author:
Jia LIU
1
;
Lidan ZHU
;
Shichun GAO
;
Huanfeng LIU
;
Lu WANG
;
Cheng ZHANG
;
Li GAO
;
Xi ZHANG
;
Peiyan KONG
;
Lei GAO
Author Information
1. 陆军军医大学第二附属医院血液病医学中心,重庆 400037
- Keywords:
blinatumomab;
allogeneic hematopoietic stem cell transplantation;
minimal residual disease-positive;
B-lineage acute lymphoblastic leukemia
- From:
Journal of Chongqing Medical University
2025;50(10):1453-1456
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate effective strategies to reduce the high risk of recurrence after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in patients with minimal residual disease(MRD)-positive B-lineage acute lymphoblastic leukemia(B-ALL).Methods:A retrospective analysis was performed for ten B-ALL patients with positive MRD before transplantation at our center from November 2022 to November 2024.There were four male patients and six female patients,with a median age of 30(7-56)years.Of all patients,four received transplantation from unrelated donors,and six received haploidentical transplantation from relatives.All ten patients received blinatumomab(28 μg/day for 14 days for patients≥45 kg;5 μg/m2/day for 14 days for patients<45 kg)and were bridged to the conditioning regimen for allo-HSCT within 7 days.Results:After treatment with blinatumomab,all ten patients achieved the clearance of MRD.After allo-HSCT,100%of the patients achieved donor hematopoietic reconstitution.The median time to neutrophil reconstitution was 12(9-22)days,and the median time to platelet reconstitution was 13.5(9-22)days.As of January 2025,the median observation time was 14(2-26)months;of all patients,two experienced recurrence,and one had positive MRD again,with a recurrence rate of 20%.Among the ten patients,nine survived and one died of disease recurrence.One patient achieved complete re-mission again after chimeric antigen receptor T-cell(CAR-T)therapy following recurrence,and the patient with positive MRD achieved the clearance of MRD again after interleukin-2 treatment;both patients were currently alive.During treatment,one patient developed cytokine release syndrome,one patient was comorbid with SARS-CoV-2 infection,one patient had herpes zoster and viral encephalitis,three patients developed grade Ⅰ-Ⅱ acute graft-versus-host disease,and four patients developed chronic graft-versus-host disease;no transplantation-associated thrombotic microangiopathy was observed.Conclusion:For patients with MRD-positive B-ALL,blinatumomab as a bridge therapy for allo-HSCT can significantly reduce recurrence after transplantation,with fewer complica-tions that are easy to control.Multicenter randomized controlled clinical studies can be performed to further verify its efficacy and safety.
