After allogeneic hematopoietic cell transplantation (HCT), patients with B-lineage acute lymphoblastic leukemia (ALL) are at significant risk of recurrence (HCT). In an effort to reduce recurrence in high-risk ALL patients, researchers undertook a single-center phase 2 research to assess the feasibility of four cycles of blinatumomab delivered every three months during the first year following HCT. About 21 of the 23 patients who were recruited in the study got at least one cycle of blinatumomab and were included in the analysis. The median period from HCT to the first blinatumomab cycle was 78 days (range, 44 to 105). All four therapy cycles were completed by 12 patients (57%). The sole grade 4 adverse event was neutropenia (19%). Cytokine release (5% G1) and neurotoxicity (5% G2) were low. 

The cumulative incidence of acute graft-versus-host disease (GVHD) grades 2 to 4 was 33% and 5%, respectively; there were 2 cases of mild (10%) and 1 case of moderate (5%) chronic GVHD. The 1-year overall survival (OS), progression-free survival (PFS), and non-relapse mortality (NRM) rates were 85%, 71%, and 0%, respectively, with a median follow-up of 14.3 months. They discovered no significant difference in blinatumomab effectiveness across groups in a matched study of 57 patients from the current day. Patients with certain T-cell profiles were classified as “responders” or “non-responders” to therapy in correlation analyses of baseline and posttreatment data. Responders showed more effector memory CD8 T-cell subsets.

Reference:ashpublications.org/blood/article-abstract/139/12/1908/483090/Blinatumomab-maintenance-after-allogeneic?redirectedFrom=fulltext