Frontline Blinatumomab in Older Adults with Philadelphia Chromosome-Negative B-Cell Acute Lymphoblastic Leukemia
Outcomes of acute lymphoblastic leukemia (ALL) in older adults treated with chemotherapy are poor. The CD19/CD3 bispecific T-cell engager (BiTE) antibody blinatumomab is approved for refractory, relapsed or minimal/measurable residual disease (MRD)-positive B-cell ALL, but there is little experience...
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| Format: | Article |
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MDPI AG
2020-06-01
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| Series: | Pharmaceuticals |
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| Online Access: | https://www.mdpi.com/1424-8247/13/6/124 |
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| author | Sandrine Niyongere Gabriela Sanchez-Petitto Jack Masur Maria R. Baer Vu H. Duong Ashkan Emadi |
| author_facet | Sandrine Niyongere Gabriela Sanchez-Petitto Jack Masur Maria R. Baer Vu H. Duong Ashkan Emadi |
| author_sort | Sandrine Niyongere |
| collection | DOAJ |
| description | Outcomes of acute lymphoblastic leukemia (ALL) in older adults treated with chemotherapy are poor. The CD19/CD3 bispecific T-cell engager (BiTE) antibody blinatumomab is approved for refractory, relapsed or minimal/measurable residual disease (MRD)-positive B-cell ALL, but there is little experience in the upfront setting, including in older patients. We retrospectively analyzed outcomes of blinatumomab monotherapy in five newly diagnosed Philadelphia chromosome-negative B-cell ALL patients over 70 years. Three had cytokine release syndrome, treated with dexamethasone and/or tocilizumab, and four patients had neurotoxicity, treated with dexamethasone, without blinatumomab interruption. All five achieved complete remission (CR) after cycle one, three with undetectable MRD. All five were alive at 8 to 15 months. Three remained in MRD-negative CR. Two relapsed after cycle 3, one with extramedullary disease. In our small cohort of patients over 70 years, blinatumomab was safe initial therapy and produced a high response rate. |
| first_indexed | 2024-03-10T19:07:47Z |
| format | Article |
| id | doaj.art-1cd08a30052f417a87f123d7935174f6 |
| institution | Directory Open Access Journal |
| issn | 1424-8247 |
| language | English |
| last_indexed | 2024-03-10T19:07:47Z |
| publishDate | 2020-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceuticals |
| spelling | doaj.art-1cd08a30052f417a87f123d7935174f62023-11-20T04:01:20ZengMDPI AGPharmaceuticals1424-82472020-06-0113612410.3390/ph13060124Frontline Blinatumomab in Older Adults with Philadelphia Chromosome-Negative B-Cell Acute Lymphoblastic LeukemiaSandrine Niyongere0Gabriela Sanchez-Petitto1Jack Masur2Maria R. Baer3Vu H. Duong4Ashkan Emadi5Departments of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USADepartments of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USADepartments of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USADepartments of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USADepartments of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USADepartments of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USAOutcomes of acute lymphoblastic leukemia (ALL) in older adults treated with chemotherapy are poor. The CD19/CD3 bispecific T-cell engager (BiTE) antibody blinatumomab is approved for refractory, relapsed or minimal/measurable residual disease (MRD)-positive B-cell ALL, but there is little experience in the upfront setting, including in older patients. We retrospectively analyzed outcomes of blinatumomab monotherapy in five newly diagnosed Philadelphia chromosome-negative B-cell ALL patients over 70 years. Three had cytokine release syndrome, treated with dexamethasone and/or tocilizumab, and four patients had neurotoxicity, treated with dexamethasone, without blinatumomab interruption. All five achieved complete remission (CR) after cycle one, three with undetectable MRD. All five were alive at 8 to 15 months. Three remained in MRD-negative CR. Two relapsed after cycle 3, one with extramedullary disease. In our small cohort of patients over 70 years, blinatumomab was safe initial therapy and produced a high response rate.https://www.mdpi.com/1424-8247/13/6/124blinatumomabacute lymphoblastic leukemia (ALL)elderly |
| spellingShingle | Sandrine Niyongere Gabriela Sanchez-Petitto Jack Masur Maria R. Baer Vu H. Duong Ashkan Emadi Frontline Blinatumomab in Older Adults with Philadelphia Chromosome-Negative B-Cell Acute Lymphoblastic Leukemia Pharmaceuticals blinatumomab acute lymphoblastic leukemia (ALL) elderly |
| title | Frontline Blinatumomab in Older Adults with Philadelphia Chromosome-Negative B-Cell Acute Lymphoblastic Leukemia |
| title_full | Frontline Blinatumomab in Older Adults with Philadelphia Chromosome-Negative B-Cell Acute Lymphoblastic Leukemia |
| title_fullStr | Frontline Blinatumomab in Older Adults with Philadelphia Chromosome-Negative B-Cell Acute Lymphoblastic Leukemia |
| title_full_unstemmed | Frontline Blinatumomab in Older Adults with Philadelphia Chromosome-Negative B-Cell Acute Lymphoblastic Leukemia |
| title_short | Frontline Blinatumomab in Older Adults with Philadelphia Chromosome-Negative B-Cell Acute Lymphoblastic Leukemia |
| title_sort | frontline blinatumomab in older adults with philadelphia chromosome negative b cell acute lymphoblastic leukemia |
| topic | blinatumomab acute lymphoblastic leukemia (ALL) elderly |
| url | https://www.mdpi.com/1424-8247/13/6/124 |
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