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.