Blinatumomab in induction therapy improves molecular response in untreated adults with Ph- B-cell precursor acute lymphoblastic leukemia

Abstract

Blinatumomab, a bispecific anti-CD3/CD19 T-cell engager, is effective in treating relapsed or refractory B-cell precursor acute lymphoblastic leukemia (B-ALL), though most patients relapse despite achieving measurable residual disease (MRD) negativity. In the MRD setting, blinatumomab induced MRD negativity (MRDneg) in 78% of patients, with 85% achieving MRD <10-4. Patients treated in their first complete remission (CR) showed better outcomes than those treated in later remissions. These findings support integrating blinatumomab into first-line polychemotherapy, as early MRD clearance significantly improves survival and reduces relapse risks.3 The open-label phase 2 Blina-CELL trial evaluated the effects of one cycle of blinatumomab following 7-day pretreatment with dexamethasone and chemotherapy in adult patients with Ph-negative B-ALL. Conducted at four centers in the Czech Republic, the trial assessed MRDneg rates after a short Pre- Induction, one cycle of blinatumomab and one cycle of high-dose chemotherapy. The study was approved by central and institutional review boards and registered on clinicaltrials.gov (NCT04554485). All participants provided informed consent in accordance with the Declaration of Helsinki.