EHA 2025 | The efficacy of blinatumomab after induction therapy in CD19-positive precursor R/R B-ALL
Maher Salamoon, MD, Al-Baironi Hospital, Damascus, Syria, discusses the efficacy of blinatumomab after induction therapy in CD19-positive precursor relapsed/refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL). Dr Salamoon reports that eight out of twelve patients achieved a complete response (CR) after the first cycle of blinatumumab, with all twelve patients achieving a CR after the second cycle. This interview took place at the 30th Congress of the European Hematology Association (EHA) in Milan, Italy.
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Transcript
As you know, blinatumumab is the first and only approved CD19-directed CD3 dual-engager T-cell immunotherapy for the treatment of those patients with precursor B-ALL with refractory and relapse disease with Philadelphia positive and Philadelphia negative in adults and children. So in our study, in my oral presentation, I have demonstrated a small cohort of 12 patients treated with blinatumumab at the end of induction...
As you know, blinatumumab is the first and only approved CD19-directed CD3 dual-engager T-cell immunotherapy for the treatment of those patients with precursor B-ALL with refractory and relapse disease with Philadelphia positive and Philadelphia negative in adults and children. So in our study, in my oral presentation, I have demonstrated a small cohort of 12 patients treated with blinatumumab at the end of induction. Those patients demonstrating a residual disease by flow cytometry including less or equal to 1% of blasts in the bone marrow. So we have started our treatment with the first dose of Blinatumumab at the dose of 9 micrograms per kilogram in the first 7 consecutive days and 28 micrograms per kilogram in the remaining eight to 28 days thereafter. And we have performed a bone marrow aspiration and evaluated by means of flow cytometry to demonstrate a complete response, I mean zero plus, after the completion of the first cycle of blinatumumab in eight out of 12 patients. However, we still have four patients demonstrating a residual disease by flow cytometry between 0.02 and 0.6%. These patients move to another cycle of blinatumumab with the same dosing schedule. So after the completion of the second cycle, all patients, 12 patients, demonstrated a good response, a complete response, zero plus in the bone marrow by means of flow cytometry. The follow up of two years in these patients demonstrated a progression-free survival and overall survival at 100%, which is a good number, which is a good statistic. And it remains to say that these kind of treatments also have side effects with ranging between headache, tremor, speech difficulties, and also we have documented seven patients with encephalopathy in which we were obliged to stop treatment or hold up treatment for a couple of days and giving a good dose of dexamethasone between 8 and 20 milligrams per day, till resolution of the symptoms. However, we can find that blinatumumab is a good choice in patients at the end of induction with residual disease in the bone marrow. However, we need also a bigger trial and bigger cohort to confirm these results.
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