Aim
To evaluate the use of Blinatumomab and HSCT as treatment in ambulatory
patients with refractory acute lymphoblastic leukemia in terms of
overall survival and disease-free survival in pediatric patients treated
at Hospital Infantil Teletón de Oncología (HITO).
Materials and methods
We conducted a retrospective, longitudinal, observational, descriptive
study where we considered variables such as: age, gender, percentage of
bone marrow blasts in relapse, extramedullary disease, and complete
remission prior to blinatumomab administration. The number of
blinatumomab cycles received and complications such as: infections,
cytokine release syndrome, overall survival rate, disease-free survival
rate, and cause of death. Pediatric patients between 0 and 18 years of
age with a diagnosis of ALL (R/R), treated with blinatumomab and HSCT
treated at HITO were included (Table 1). A multidisciplinary team
composed of physicians, nurses, and pharmacists was created to address
administration challenges associated with blinatumomab infusions.
Although blinatumomab requires a 28-day continuous infusion, it is not
necessary for patients to remain hospitalized for the entire cycle. To
ensure tolerability prior to discharge, patients are monitored closely
during the first 3 days of Cycle 1 for signs of cytokine release
syndrome and neurological toxicities. Once discharged to the shelter,
next to the hospital, the patients remain under supervision, where we
check them every 72 hours for infusion pump bag change.
The population was non-randomized, consecutively diagnosed with ALL
(R/R) according to hospital records from January 1st,
2015, to June 1st, 2020. Statistical analysis was
performed using SPSS version 25.0 software. All transplants were
performed with informed consent signed by the responsible of the
patients under 18 years of age.