Results
Blinatumomab was administered as treatment for R/R ALL prior to HSCT in
9 patients (Table 1). The mean age at the time of administration was
10.1 years with a SD ±4.84. The distribution of cases by gender
corresponds to 66% women (n= 5) and 44% men (n=4). All patients had an
oncological diagnosis of ALL and 100% of them presented refractoriness
and/or relapse. In the evaluation prior to the administration of
Blinatumomab, 88.8% of the patients presented positive MRD (N=8) and
11.2% of the negative cases (N=1). No patient had extramedullary
disease, the number of cycles of Blinatumomab received to achieve
complete remission and negative MRD were different; 4 patients received
1 cycle (44%), 3 patients received 3 cycles (33%), and 2 patients
received 2 cycles (22.2%), 56% of the cases achieved deep complete
remission at the end of treatment or at the last consultation, 12%
achieved a first complete remission with one blinatumomab cycle and 88%
required a second or third cycle to achieve it.
Complications: 33% of the patients presented Cytokine Release Syndrome
(n=3), with 22% being moderate grade and the most frequent (n=2) and
11% mild (n=1). 2 were admitted to the Pediatric Intensive Care Unit.
A 3-year disease-free survival and overall survival of 55% was
determined (Graph 1). Brown and cols conclude that the comparing high
and intermediate risk first relapse of B-ALL, post reinduction treatment
with blinatumomab compared with chemotherapy followed by transplant is
not statistically significant with disease free survival. Our series
includes only refractory ALL patients which represent a very positive
result. Adverse events are like the ones described in the literature.