EHA 2026 | Insights from the AIEOP-BFM ALL trial: could blinatumomab replace high-dose chemotherapy in HR ALL?
Martin Schrappe, MD, FRCP, University Medical Center Schleswig-Holstein, Kiel, Germany, shares insight into the AIEOP-BFM ALL 2017 trial (NCT03643276), which evaluates blinatumomab, a bispecific antibody, as a replacement for high-dose chemotherapy in pediatric patients with newly diagnosed high-risk (HR) acute lymphoblastic leukemia (ALL). Prof. Schrappe highlights the superior efficacy of blinatumomab over standard chemotherapy, supporting a shift from intensive chemotherapy to immunotherapy in frontline treatment. This interview took place at the 31st Congress of the European Hematology Association (EHA) in Stockholm, Sweden.
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Transcript
High-risk ALL is the minority of patients with ALL in this age group. But nevertheless, they are carrying a significant treatment burden because they need the most chemotherapy. So in the past few years, this was a little bit frustrating because the side effects are quite significant, the acute but also the late side effects. And therefore, we wanted to introduce something which is less burdensome for the patients...
High-risk ALL is the minority of patients with ALL in this age group. But nevertheless, they are carrying a significant treatment burden because they need the most chemotherapy. So in the past few years, this was a little bit frustrating because the side effects are quite significant, the acute but also the late side effects. And therefore, we wanted to introduce something which is less burdensome for the patients. And this, we hope, would be immunotherapy using a bispecific antibody called blinatumomab. And we randomized blinatumomab instead of two cycles of very heavy chemotherapy versus the conventional arm using the full-scale chemotherapy. And the primary aim was very clear very soon that this is less toxic, but we didn’t know if it’s also at least the same, if it delivers the same efficacy or even better efficacy. And in the end, and this will be reported here, we could show that the efficacy was actually much higher, significantly higher than even the group of patients who received the standard chemotherapy. I think this marks a real turning point in leukemia treatment because it shows that you can back off from toxic chemotherapy and be able to replace it by cycles of immunotherapy. In the long run, we will see how much you can reduce because we don’t want to risk the overall achievement in childhood leukemia, which is a survival of 90%.
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