13
views
0
recommends
+1 Recommend
2 collections
    0
    shares

      Call for Papers: Digital Diagnostic Techniques

      Submit here before November 30, 2024

      About Pathobiology: 3.5 Impact Factor I 8.5 CiteScore I 1.088 Scimago Journal & Country Rank (SJR)

      Call for Papers: Supportive Care - Essential for Modern Oncology

      Submit here before December 31, 2024

      About Oncology Research and Treatment: 2.0 Impact Factor I 3.2 CiteScore I 0.521 Scimago Journal & Country Rank (SJR)

      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Combination of Donor Lymphocyte Infusion and Blinatumomab for B-Cell Lymphoblastic Lymphoma Relapse after Allogeneic Stem-Cell Transplantation

      case-report

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          A woman in her forties with relapsed B-cell lymphoblastic lymphoma was treated with blinatumomab, but the drug proved ineffective. Salvage therapy with clofarabine induced a complete remission, and she received an allogeneic stem-cell transplantation (allo-SCT) from an HLA-matched sibling donor. However, her disease relapsed only 4 months after the allo-SCT. Three courses of combination therapy with donor lymphocyte infusion (DLI) and blinatumomab were administered, and the tumor progression was well controlled for 6 months, leading to a second allo-SCT from an HLA-haploidentical donor. The remission was persistent for approximately 1 year, but the disease relapsed in her central nervous system, and she eventually died. Our case demonstrated the efficacy and safety of concomitant use of DLI and blinatumomab. This combination presumably enhanced a graft-versus-lymphoma effect of allogeneic T-cells without provoking graft-versus-host disease.

          Related collections

          Most cited references11

          • Record: found
          • Abstract: found
          • Article: found

          Blinatumomab versus Chemotherapy for Advanced Acute Lymphoblastic Leukemia

          Background Blinatumomab, a bispecific monoclonal antibody construct that enables CD3-positive T cells to recognize and eliminate CD19-positive acute lymphoblastic leukemia (ALL) blasts, was approved for use in patients with relapsed or refractory B-cell precursor ALL on the basis of single-group trials that showed efficacy and manageable toxic effects. Methods In this multi-institutional phase 3 trial, we randomly assigned adults with heavily pretreated B-cell precursor ALL, in a 2:1 ratio, to receive either blinatumomab or standard-of-care chemotherapy. The primary end point was overall survival. Results Of the 405 patients who were randomly assigned to receive blinatumomab (271 patients) or chemotherapy (134 patients), 376 patients received at least one dose. Overall survival was significantly longer in the blinatumomab group than in the chemotherapy group. The median overall survival was 7.7 months in the blinatumomab group and 4.0 months in the chemotherapy group (hazard ratio for death with blinatumomab vs. chemotherapy, 0.71; 95% confidence interval [CI], 0.55 to 0.93; P=0.01). Remission rates within 12 weeks after treatment initiation were significantly higher in the blinatumomab group than in the chemotherapy group, both with respect to complete remission with full hematologic recovery (34% vs. 16%, P<0.001) and with respect to complete remission with full, partial, or incomplete hematologic recovery (44% vs. 25%, P<0.001). Treatment with blinatumomab resulted in a higher rate of event-free survival than that with chemotherapy (6-month estimates, 31% vs. 12%; hazard ratio for an event of relapse after achieving a complete remission with full, partial, or incomplete hematologic recovery, or death, 0.55; 95% CI, 0.43 to 0.71; P<0.001), as well as a longer median duration of remission (7.3 vs. 4.6 months). A total of 24% of the patients in each treatment group underwent allogeneic stem-cell transplantation. Adverse events of grade 3 or higher were reported in 87% of the patients in the blinatumomab group and in 92% of the patients in the chemotherapy group. Conclusions Treatment with blinatumomab resulted in significantly longer overall survival than chemotherapy among adult patients with relapsed or refractory B-cell precursor ALL. (Funded by Amgen; TOWER ClinicalTrials.gov number, NCT02013167 .).
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Effect of Blinatumomab vs Chemotherapy on Event-Free Survival Among Children With High-risk First-Relapse B-Cell Acute Lymphoblastic Leukemia: A Randomized Clinical Trial

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Outcomes and prognostic factors of adults with acute lymphoblastic leukemia who relapse after allogeneic hematopoietic cell transplantation. An analysis on behalf of the Acute Leukemia Working Party of EBMT.

              To describe outcomes, treatment and prognostic factors that influence survival of adult patients with acute lymphoblastic leukemia (ALL), who relapsed after allogeneic hematopoietic cell transplantation (HCT), we retrospectively analyzed 465 ALL adult patients from European Group for Blood and Marrow Transplantation (EBMT) centers who relapsed after a first HCT performed in complete remission (CR1 65%, CR2/3 35%). Salvage treatments were: supportive care (13%), cytoreductive therapy (43%), donor lymphocyte infusion without or with prior chemotherapy (23%) and second HCT (20%). Median time from HCT to relapse was 6.9 months, median follow-up was 46 months and median survival after relapse was 5.5 months. Estimated 1-, 2- and 5-year post-relapse survival was 30 ± 2%, 16 ± 2% and 8 ± 1%, respectively. In a multivariate analysis, adverse factors for survival were: late CR (CR2/3) at transplant (P<0.012), early relapse after transplant (<6.9 months, P <0.0001) and peripheral blast percent at relapse (P <0.0001). On the basis of multivariate model for survival, three groups of patients were identified with estimated 2 year survival of 6 ± 2, 17 ± 3 and 30 ± 7%. Outcome of ALL patients relapsing after HCT is dismal and there is a need for new therapies. Our study provides the standard expectations in ALL relapse and may help in the decision of post-relapse therapy.
                Bookmark

                Author and article information

                Journal
                Case Rep Oncol
                Case Rep Oncol
                CRO
                CRO
                Case Reports in Oncology
                S. Karger AG (Basel, Switzerland )
                1662-6575
                16 August 2023
                Jan-Dec 2023
                16 August 2023
                : 16
                : 1
                : 640-644
                Affiliations
                [a ]Research Institute of Innovative Medicine, Tokiwa Foundation, Iwaki, Japan
                [b ]Graduate School of Life Science and Engineering, Iryo Sosei University, Iwaki, Japan
                [c ]School of Medicine, Fukushima Medical University, Fukushima, Japan
                [d ]Department of Hematology, Jyoban Hospital, Tokiwa Foundation, Iwaki, Japan
                [e ]Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
                Author notes
                Correspondence to: Jinichi Mori, jinichimori@ 123456gmail.com
                Article
                531834
                10.1159/000531834
                10601734
                37900800
                74277c41-9d07-45fd-ac10-74ba34115cf4
                © 2023 The Author(s). Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution 4.0 International License (CC BY) ( http://www.karger.com/Services/OpenAccessLicense). Usage, derivative works and distribution are permitted provided that proper credit is given to the author and the original publisher.

                History
                : 26 November 2022
                : 19 June 2023
                : 2023
                Page count
                Figures: 1, Tables: 1, References: 11, Pages: 5
                Funding
                There is no funding source for this work.
                Categories
                Case Report

                Oncology & Radiotherapy
                blinatumomab,donor lymphocyte infusion,b-cell lymphoblastic lymphoma,allogeneic stem-cell transplantation

                Comments

                Comment on this article