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      Blinatumomab may induce graft versus host leukemia in patients with pre‐B ALL relapsing after hematopoietic stem cell transplant

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          Key Clinical Message

          Blinatumomab, a bispecific T‐cell engager monoclonal antibody used to manage Philadelphia chromosome‐negative relapsed or refractory B‐cell precursor acute lymphoblastic leukemia ( ALL) can be used to treat patients by inducing graft versus leukemia reaction post allogeneic hematopoietic stem cell transplantation, a feature which it was post allogeneic bone marrow transplantation, a feature which this drug was not aimed to do.

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          Reporting results of cancer treatment.

          A Miller, B Hoogstraten, M. Staquet … (1981)
          On the initiative of the World Health Organization, two meetings on the Standardization of Reporting Results of Cancer Treatment have been held with representatives and members of several organizations. Recommendations have been developed for standardized approaches to the recording of baseline data relating to the patient, the tumor, laboratory and radiologic data, the reporting of treatment, grading of acute and subacute toxicity, reporting of response, recurrence and disease-free interval, and reporting results of therapy. These recommendations, already endorsed by a number of organizations, are proposed for international acceptance and use to make it possible for investigators to compare validly their results with those of others.
          Article 0 comments Cited 502 times – based on 0 reviews     Review now
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            Targeted therapy with the T-cell-engaging antibody blinatumomab of chemotherapy-refractory minimal residual disease in B-lineage acute lymphoblastic leukemia patients results in high response rate and prolonged leukemia-free survival.

            Max Topp, Peter Kufer, Nicola Gökbuget … (2011)
            Blinatumomab, a bispecific single-chain antibody targeting the CD19 antigen, is a member of a novel class of antibodies that redirect T cells for selective lysis of tumor cells. In acute lymphoblastic leukemia (ALL), persistence or relapse of minimal residual disease (MRD) after chemotherapy indicates resistance to chemotherapy and results in hematologic relapse. A phase II clinical study was conducted to determine the efficacy of blinatumomab in MRD-positive B-lineage ALL. Patients with MRD persistence or relapse after induction and consolidation therapy were included. MRD was assessed by quantitative reverse transcriptase polymerase chain reaction for either rearrangements of immunoglobulin or T-cell receptor genes, or specific genetic aberrations. Blinatumomab was administered as a 4-week continuous intravenous infusion at a dose of 15 μg/m2/24 hours. Twenty-one patients were treated, of whom 16 patients became MRD negative. One patient was not evaluable due to a grade 3 adverse event leading to treatment discontinuation. Among the 16 responders, 12 patients had been molecularly refractory to previous chemotherapy. Probability for relapse-free survival is 78% at a median follow-up of 405 days. The most frequent grade 3 and 4 adverse event was lymphopenia, which was completely reversible like most other adverse events. Blinatumomab is an efficacious and well-tolerated treatment in patients with MRD-positive B-lineage ALL after intensive chemotherapy. T cells engaged by blinatumomab seem capable of eradicating chemotherapy-resistant tumor cells that otherwise cause clinical relapse.
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              Author and article information

              Journal
              Journal ID (nlm-ta): Clin Case Rep
              Journal ID (iso-abbrev): Clin Case Rep
              Journal ID (doi): 10.1002/(ISSN)2050-0904
              Journal ID (publisher-id): CCR3
              Title: Clinical Case Reports
              Publisher: John Wiley and Sons Inc. (Hoboken )
              ISSN (Electronic): 2050-0904
              Publication date (Electronic): 24 June 2016
              Publication date Collection: August 2016
              Volume: 4
              Issue: 8 ( doiID: 10.1111/ccr3.2016.4.issue-8 )
              Pages: 743-746
              Affiliations
              [ 1 ] Department of Internal medicine Division of Hematology/Bone Marrow TransplantationUniversity of Kentucky Lexington Kentucky
              Author notes
              [*] [* ] Correspondence

              Muhammad Waqas Khan, Markey Cancer Center, University of Kentucky, 800 Rose Street, Lexington, KY 40536. Tel: +859‐323‐0706; Fax: +859‐257‐375; E‐mail: mkh233@ 123456uky.edu

              Article
              Publisher ID: CCR3604
              DOI: 10.1002/ccr3.604
              PMC ID: 4974418
              PubMed ID: 27525074
              SO-VID: 3785038c-98de-4592-9736-1a867bd1d0b0
              Copyright © © 2016 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.
              License:

              This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

              History
              Date received : 26 November 2015
              Date revision received : 01 April 2016
              Date accepted : 22 May 2016
              Page count
              Pages: 4
              Categories
              Subject: Case Report
              Subject: Case Reports
              Custom metadata
              source-schema-version-number 2.0
              component-id ccr3604
              cover-date August 2016
              details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:4.9.4 mode:remove_FC converted:05.08.2016

              Keywords: bite antibody in all,blinatumomab in pre‐b all,post transplant all management,refractory all treatment
              Data availability:
              Keywords: bite antibody in all, blinatumomab in pre‐b all, post transplant all management, refractory all treatment

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