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Hematology Reports
Volume 16
Issue 2
10.3390/hematolrep16020035
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Background:
Case Report

Blinatumomab in Children with MRD-Positive B-Cell Precursor Acute Lymphoblastic Leukemia: A Report of 11 Cases

by
Yi-Lun Wang
1,
Tsung-Yen Chang
1,
Yu-Chuan Wen
2,
Shu-Ho Yang
2,
Yi-Wen Hsiao
2,
Chia-Chi Chiu
2,
Yu-Chieh Chen
3,4,
Ruei-Shan Hu
4,
Shih-Hsiang Chen
1,4,
Tang-Her Jaing
1,4,* and
Chih-Cheng Hsiao
3,4
1
Department of Pediatrics, Division of Hematology/Oncology, Chang Gung Memorial Hospital, Taoyuan 33315, Taiwan
2
Department of Nursing, Chang Gung Memorial Hospital, Taoyuan 33315, Taiwan
3
Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
4
College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
*
Author to whom correspondence should be addressed.
Hematol. Rep. 2024, 16(2), 347-353; https://doi.org/10.3390/hematolrep16020035
Submission received: 9 August 2023 / Revised: 1 May 2024 / Accepted: 28 May 2024 / Published: 3 June 2024
(This article belongs to the Topic Myeloma and Leukemia-Challenges and Current Treatment Options)
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Abstract

Background/Objectives: Relapsed B-cell acute lymphoblastic leukemia (B-ALL) remains an unresolved matter of concern regarding adverse outcomes. This case study aimed to evaluate the effectiveness of blinatumomab, with or without door lymphocyte infusion (DLI), in treating measurable residual disease (MRD)-positive B-ALL. Methods: All patients who received blinatumomab salvage therapy were included in this study. Eleven patients were included in the study. All patients were evaluated for MRD-negativity. Results: Before starting blinatumomab therapy, seven patients tested positive for MRD, three tested negative, and one had refractory disease. Hematopoietic cell transplantation (HCT) was reserved for five patients with persistent MRD. Six patients became MRD-negative and subsequent HCT was not performed. Only two patients relapsed; one patient died of relapse, and the other one received carfilzomib-based therapy and was MRD-negative thereafter. Nine patients were MRD-negative at a median follow-up of 28 months (15–52 months). Two of three MRD-positive post-transplant patients remained in complete molecular remission after preemptive DLI at the last follow-up date. In the first salvage, blinatumomab may achieve complete remission and bridging to HCT in pediatric patients with end-of-induction MRD-positive B-cell precursor ALL. Conclusions: The decision on how to treat post-transplant relapse continues to affect survival outcomes. Blinatumomab combined with DLI may extend the armamentarium of release options for high-risk pediatric patients. This approach is encouraging for high-risk ALL patients who are MRD-positive post-transplantation.
Keywords: blinatumomab; measurable residual disease; acute lymphoblastic leukemia; hematopoietic cell transplantation; donor lymphocyte infusion blinatumomab; measurable residual disease; acute lymphoblastic leukemia; hematopoietic cell transplantation; donor lymphocyte infusion

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MDPI and ACS Style

Wang, Y.-L.; Chang, T.-Y.; Wen, Y.-C.; Yang, S.-H.; Hsiao, Y.-W.; Chiu, C.-C.; Chen, Y.-C.; Hu, R.-S.; Chen, S.-H.; Jaing, T.-H.; et al. Blinatumomab in Children with MRD-Positive B-Cell Precursor Acute Lymphoblastic Leukemia: A Report of 11 Cases. Hematol. Rep. 2024, 16, 347-353. https://doi.org/10.3390/hematolrep16020035

AMA Style

Wang Y-L, Chang T-Y, Wen Y-C, Yang S-H, Hsiao Y-W, Chiu C-C, Chen Y-C, Hu R-S, Chen S-H, Jaing T-H, et al. Blinatumomab in Children with MRD-Positive B-Cell Precursor Acute Lymphoblastic Leukemia: A Report of 11 Cases. Hematology Reports. 2024; 16(2):347-353. https://doi.org/10.3390/hematolrep16020035

Chicago/Turabian Style

Wang, Yi-Lun, Tsung-Yen Chang, Yu-Chuan Wen, Shu-Ho Yang, Yi-Wen Hsiao, Chia-Chi Chiu, Yu-Chieh Chen, Ruei-Shan Hu, Shih-Hsiang Chen, Tang-Her Jaing, and et al. 2024. "Blinatumomab in Children with MRD-Positive B-Cell Precursor Acute Lymphoblastic Leukemia: A Report of 11 Cases" Hematology Reports 16, no. 2: 347-353. https://doi.org/10.3390/hematolrep16020035

APA Style

Wang, Y.-L., Chang, T.-Y., Wen, Y.-C., Yang, S.-H., Hsiao, Y.-W., Chiu, C.-C., Chen, Y.-C., Hu, R.-S., Chen, S.-H., Jaing, T.-H., & Hsiao, C.-C. (2024). Blinatumomab in Children with MRD-Positive B-Cell Precursor Acute Lymphoblastic Leukemia: A Report of 11 Cases. Hematology Reports, 16(2), 347-353. https://doi.org/10.3390/hematolrep16020035

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