J Clin Oncol: Efficacy of blinatumomab-induced consolidation + POMP maintenance in elderly patients with Ph chromosome-negative B-ALL

To date, chemotherapy outcomes in elderly patients with Philadelphia (Ph) chromosome-negative B acute lymphoblastic leukemia (ALL) are still very poor, with a 5-year productivity of only 6%-20% , and new and effective treatments are urgently needed
.

CD19 is expressed on most precursor B-ALL cells and is a potential therapeutic target

Chemotherapy remains very poor in elderly patients with Philadelphia (Ph) chromosome-negative B acute lymphoblastic leukemia (ALL), with a 5-year productivity of only 6%-20% leukemia

The anti-CD19 bispecific T cell-binding antibody Blinatumomab (blinatumomab) has demonstrated significant antitumor activity in both relapsed/refractory ALL and minimal residual disease (MRD)-positive B-ALL
.

In this study, investigators evaluated the efficacy of blinatumomab as induction and consolidation therapy followed by maintenance chemotherapy with prednisone, vincristine, 6-mercaptopurine, and methotrexate (POMP) in this patient population.
Efficacy and safety
.

Treatment process

Treatment process

Newly diagnosed Ph-chromosome-negative B-ALL patients aged 65 years and older were recruited for 1-2 cycles of induction therapy with blinatumomab until remission (complete remission [CR] and CR with incomplete blood count recovery)
.

This was followed by three cycles of consolidation with blinatumomab followed by maintenance chemotherapy with POMP for 18 months

prevention

Disease-free survival and overall survival

Disease-free survival and overall survival

A total of 92 patients were recruited, with a median age of 75 years and a median bone marrow blast count of 87% at diagnosis
.

Ten patients (34%) had poor cytogenetic risk, and 5 of 14 patients (36%) had a Ph-like ALL genetic signature

Nine patients (66%) achieved complete remission

Adverse Reactions During Partial Induction Therapy

Adverse Reactions During Partial Induction Therapy

In conclusion, blinatumomab was well tolerated and effective in the treatment of elderly patients with newly diagnosed Ph chromosome-negative B-ALL, including those at poor cytogenetic risk
.

The 3-year disease-free survival and overall survival results were encouraging and suggest that this treatment option deserves further exploration

blinatumomab was well tolerated and effective in the treatment of elderly patients with newly diagnosed Ph chromosome-negative B-ALL, including those at poor cytogenetic risk.

Original source:

Anjali S.

SWOG 1318: A Phase II Trial of Blinatumomab Followed by POMP Maintenance in Older Patients With Newly Diagnosed Philadelphia Chromosome–Negative B-Cell Acute Lymphoblastic Leukemia Leave a Comment