Blinatumomab may improve outcomes in patients with B-cell ALL undergoing ASCT

In a retrospective study, pre-transplantation blinatumomab was linked to better overall survival and reduced treatment-related mortality in patients with B-cell acute lymphoblastic leukaemia (ALL) undergoing allogeneic stem cell transplantation (ASCT).

A retrospective study investigated the efficacy of pre-transplant blinatumomab in patients with B-cell ALL undergoing ASCT. Out of the 117 participants undergoing ASCT for B-cell ALL, 31 had received pre-transplant blinatumomab and 86 participants had not. The primary outcomes were overall survival (OS) and transplant-related mortality. Dr Ayman Sayyed (University of Toronto, Canada) presented the findings.

The median OS was 42 months in the blinatumomab group compared with 13 months in the non-blinatumomab group (HR 0.50; 95% CI 0.26–1.00; P=0.05). Furthermore, a multivariate analysis showed that blinatumomab (HR 0.48), total body irradiation (TBI)-based conditioning (HR 0.26), and paediatric-inspired induction protocol (HR 0.18) were significant independent factors, positively influencing survival. A mismatched donor was negatively associated with survival (HR 3.47). Considering transplant-related mortality, only 3.2% of the patients in the blinatumomab group had a transplant-related death compared with 43.0% of the patients in the non-blinatumomab group (HR 0.06; P=0.007). Dr Sayyed added that the cumulative incidence of relapse was higher in the blinatumomab arm than in the non-blinatumomab arm (34.4% vs 14.4%; HR 2.6; P=0.02).

1. 1. Sayyed A, et al. Pre-transplant blinatumomab improves outcomes in B-cell acute lymphoblastic leukemia patients who undergo allogeneic hematopoietic cell transplantation. OS06-05, European Society for Blood and Marrow Transplantation (EBMT) 49^th Annual Meeting, 23–26 April 2023, Paris, France.

 

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Posted on 2 May, 202316 May, 2023