Nicola Gökbuget, Gerhard Zugmaier, Hervé Dombret, Anthony Stein, Massimiliano Bonifacio, Carlos Graux, Christoph Faul, Monika Brüggemann, Kate Taylor, Noemi Mergen, Albrecht Reichle, Heinz-August Horst, Violaine Havelange, Max S Topp, Ralf C Bargou
Leukemia & lymphoma 2020 NovMinimal residual disease (MRD) is the strongest predictor of relapse in B-cell precursor acute lymphoblastic leukemia (BCP-ALL). In BLAST study (NCT01207388), adults with BCP-ALL in remission with MRD after chemotherapy received blinatumomab, a CD19 BiTE® immuno-oncotherapy, 15 µg/m2/day for up to four 6-week cycles (4 weeks continuous infusion, 2 weeks off). Survival was evaluated for 110 patients, including 74 who received HSCT in continuous complete remission. With a median follow-up of 59·8 months, median survival (months) was 36·5 (95% CI: 22.0-not reached [NR]). Median survival was NR (29.5-NR) for complete MRD responders (n = 84) and 14.4 (3.8-32.3) for MRD non-responders (n = 23; p = 0.002); after blinatumomab and HSCT, median survival was NR (25.7-NR) (n = 61) and 16.5 (1.1-NR) (n = 10; p = 0.065), respectively. This final analysis suggests complete MRD response during blinatumomab treatment is curative. Post-hoc analysis of study data suggests while post blinatumomab HSCT may be beneficial in appropriate patients, long-term survival without HSCT is also possible.
Nicola Gökbuget, Gerhard Zugmaier, Hervé Dombret, Anthony Stein, Massimiliano Bonifacio, Carlos Graux, Christoph Faul, Monika Brüggemann, Kate Taylor, Noemi Mergen, Albrecht Reichle, Heinz-August Horst, Violaine Havelange, Max S Topp, Ralf C Bargou. Curative outcomes following blinatumomab in adults with minimal residual disease B-cell precursor acute lymphoblastic leukemia. Leukemia & lymphoma. 2020 Nov;61(11):2665-2673
PMID: 32619115
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