Blinatumomab following haematopoietic stem cell transplantation – a novel approach for the treatment of acute lymphoblastic leukaemia in infants
Corresponding Author
Alexander Popov
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Correspondence: Alexander Popov, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, 1, S. Mashela st., Moscow, 117998, Russian Federation.
E-mail: [email protected]
Search for more papers by this authorVeronika Fominikh
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorEkaterina Mikhailova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorLarisa Shelikhova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorGrigory Tsaur
Regional Children’s Hospital, Ekaterinburg, Russian Federation
Research Institute of Medical Cell Technologies, Ekaterinburg, Russian Federation
Search for more papers by this authorYulia Abugova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorElena Zerkalenkova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorYulia Olshanskaya
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorDmitry Balashov
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorGalina Novichkova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorAlexey Maschan
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorNatalia Miakova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorCorresponding Author
Alexander Popov
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Correspondence: Alexander Popov, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, 1, S. Mashela st., Moscow, 117998, Russian Federation.
E-mail: [email protected]
Search for more papers by this authorVeronika Fominikh
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorEkaterina Mikhailova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorLarisa Shelikhova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorGrigory Tsaur
Regional Children’s Hospital, Ekaterinburg, Russian Federation
Research Institute of Medical Cell Technologies, Ekaterinburg, Russian Federation
Search for more papers by this authorYulia Abugova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorElena Zerkalenkova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorYulia Olshanskaya
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorDmitry Balashov
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorGalina Novichkova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorAlexey Maschan
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorNatalia Miakova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
Search for more papers by this authorSummary
Blinatumomab with subsequent haematopoietic stem cell transplantation was applied in 13 infants with acute lymphoblastic leukaemia (ALL). Eight patients were treated in first remission due to slow clearance of minimal residual disease (MRD); one for MRD-reappearance after long MRD negativity, one for primary refractory disease and three during relapse treatment. In slow MRD responders, complete MRD response was achieved prior to transplantation, with an 18-month event-free survival of 75%. In contrast, only one of five patients with relapsed/refractory ALL is still in complete remission. These data provide a basis for future studies of immunotherapy in very high-risk infant ALL.
Conflict of interest
Authors declare no relevant conflicts of interests.
Supporting Information
Filename | Description |
---|---|
bjh17466-sup-0001-TableS1.docxWord document, 17.9 KB | Table SI. Initial patient characteristics. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
References
- 1Tomizawa D. Recent progress in the treatment of infant acute lymphoblastic leukemia. Pediatr Int. 2015; 57: 811–9.
- 2Pieters R, De Lorenzo P, Ancliffe P, Aversa LA, Brethon B, Biondi A, et al. Outcome of infants younger than 1 year with acute lymphoblastic leukemia treated with the Interfant-06 protocol: results from an international phase III randomized study. J Clin Oncol. 2019; 37: 2246–56.
- 3Brown PA. Neonatal leukemia. Clin Perinatol. 2021; 48(1): 15–33.
- 4Dordelmann M, Reiter A, Borkhardt A, Ludwig WD, Gotz N, Viehmann S, et al. Prednisone response is the strongest predictor of treatment outcome in infant acute lymphoblastic leukemia. Blood. 1999; 94: 1209–17.
- 5Stutterheim J, van der Sluis IM, de Lorenzo P, Alten J, Ancliffe P, Attarbaschi A, et al. Clinical implications of minimal residual disease detection in infants with KMT2A-rearranged acute lymphoblastic leukemia treated on the Interfant-06 protocol. J Clin Oncol. 2021; 39: 652–62.
- 6Tsaur G, Popov A, Riger T, Kustanovich A, Solodovnikov A, Shorikov E, et al. Prognostic value of minimal residual disease measured by fusion-gene transcript in infants with KMT2A-rearranged acute lymphoblastic leukaemia treated according to the MLL-Baby protocol. Br J Haematol. 2021 [Online ahead of print]. https://doi.org/10.1111/bjh.17304
- 7Popov A, Buldini B, De Lorenzo P, Disaro S, Verzhbitskaya T, Movchan L, et al. Prognostic value of minimal residual disease measured by flow-cytometry in two cohorts of infants with acute lymphoblastic leukemia treated according to either MLL-Baby or Interfant protocols. Leukemia. 2020; 34: 3042–6.
- 8Driessen EM, de Lorenzo P, Campbell M, Felice M, Ferster A, Hann I, et al. Outcome of relapsed infant acute lymphoblastic leukemia treated on the interfant-99 protocol. Leukemia. 2016; 30: 1184–7.
- 9Sison EA, Brown P. Does hematopoietic stem cell transplantation benefit infants with acute leukemia? Hematology. 2013; 2013: 601–4.
- 10von Stackelberg A, Locatelli F, Zugmaier G, Handgretinger R, Trippett TM, Rizzari C, et al. Phase I/phase II study of blinatumomab in pediatric patients with relapsed/refractory acute lymphoblastic leukemia. J Clin Oncol. 2016; 34: 4381–9.
- 11Keating AK, Gossai N, Phillips CL, Maloney K, Campbell K, Doan A, et al. Reducing minimal residual disease with blinatumomab prior to HCT for pediatric patients with acute lymphoblastic leukemia. Blood Adv. 2019; 3: 1926–9.
- 12Mikhailova E, Gluhanyuk E, Illarionova O, Zerkalenkova E, Kashpor S, Miakova N, et al. Immunophenotypic changes of leukemic blasts in children with relapsed/refractory B-cell precursor acute lymphoblastic leukemia, who have been treated with Blinatumomab. Haematologica. 2020 [Online ahead of print]. https://doi.org/10.3324/haematol.2019.241596.
- 13Fuster JL, Molinos-Quintana A, Fuentes C, Fernandez JM, Velasco P, Pascual T, et al. Blinatumomab and inotuzumab for B cell precursor acute lymphoblastic leukaemia in children: a retrospective study from the Leukemia Working Group of the Spanish Society of Pediatric Hematology and Oncology (SEHOP). Br J Haematol. 2020; 190: 764–71.
- 14Clesham K, Rao V, Bartram J, Ancliff P, Ghorashian S, O'Connor D, et al. Blinatumomab for infant acute lymphoblastic leukemia. Blood. 2020; 135: 1501–4.
- 15Gardner R, Wu D, Cherian S, Fang M, Hanafi LA, Finney O, et al. Acquisition of a CD19-negative myeloid phenotype allows immune escape of MLL-rearranged B-ALL from CD19 CAR-T-cell therapy. Blood. 2016; 127: 2406–10.
- 16Bader P, Salzmann-Manrique E, Balduzzi A, Dalle JH, Woolfrey AE, Bar M, et al. More precisely defining risk peri-HCT in pediatric ALL: pre- vs post-MRD measures, serial positivity, and risk modeling. Blood Adv. 2019; 3: 3393–405.