Retrospective study on the treatment of chemotherapy intolerance B-cell acute lymphoblastic leukemia in children with Blinatumomab
10.3760/cma.j.issn.1673-4912.2025.10.006
- VernacularTitle:贝林妥欧单抗在儿童化疗不耐受急性淋巴细胞白血病中的应用：一项回顾性分析
- Author:
Min HE
1
;
Xinyu HE
1
;
Hailing LIU
1
;
Ding DING
1
;
Man XU
1
;
Guoli LIAN
1
;
Zhigang LIU
1
Author Information
1. 西安交通大学第一附属医院儿科 710061
- Publication Type:Journal Article
- Keywords:
Blinatumomab;
Acute lymphoblastic leukemia;
Children;
Tolerability
- From:
Chinese Pediatric Emergency Medicine
2025;32(10):743-747
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the safety and efficacy of Blinatumomab in treating children with acute B-lymphoblastic leukemia（B-ALL）.Methods:The clinical data of 10 B-ALL children who were admitted to the Department of Pediatrics，the First Affiliated Hospital of Xi’an Jiaotong University from May 2022 to April 2024 and treated with Blinatumomab were analyzed retrospectively.Results:All the 10 cases had a complete remission of bone marrow and all minimal residual disease（MRD）were negative. Serious adverse events were reported after chemotherapy，including intracranial venous sinus thrombosis with acute cerebral infarction，acute pancreatitis，paralytic ileus，syndrome of abnormal secretion of antidiuretic hormone，severe pneumonia，liver injury，sepsis（β-lactamase resistant Escherichia coli，Pseudomonas aeruginosa），oral mucositis，persistent agranulocytosis with bloodstream infection. All patients interrupted chemotherapy and received Blinatumomab injections for 14 days. During treatment，there was hematological toxicity，which resulted in grade 3-4 neutropenia in 5 cases within the first 7 days. Transient low-grade fever was observed in 4 cases of non-hematological toxicity during days 1-3 of treatment. One patient experienced a headache on the 7th day of treatment，which worsened on the 14th day，but it improved with mannitol treatment. Mild liver injury was present in 3 cases. Interleukin-6 reached a peak of 71.86 pg/mL on the second day of treatment in one case，whereas it was normal in others. All patients were found to be free of cytokine release syndrome. T lymphocyte count increased in 5 patients after 14 days of Blinatumomab treatment，but B lymphocyte count and serum immunoglobulin levels declined in 10 patients. Hypogammaglobulinemia was observed in 3 of these patients. The median follow-up time was 7.8（3.0-24.0）months. All patients achieved MRD-negative complete remission and 6-month overall survival rate and progression-free survival were both 100%.Conclusion:Children with B-ALL can benefit from using Blinatumomab，which is safer than conventional chemotherapy，as a new treatment strategy for those who cannot tolerate traditional chemotherapy.
