Stem cell transplant after blinatumomab in patients with relapsed or unresponsive acute lymphoblastic leukemia

This study aimed to investigate the outcomes for patients who underwent allogeneic hematopoietic stem cell transplant after treatment with blinatumomab. 

This study concluded that survival was driven by the response to study treatment and by salvage status regardless of transplant status.  

Blinatumomab (Blincyto) is a targeted therapy. It is used as a second-line treatment for Philadelphia chromosome-negative relapsed/unresponsive acute lymphoblastic leukemia (ALL). Philadelphia chromosome is an abnormal chromosome found in leukemic cancer cells. Blinatumomab showed higher overall survival when compared to standard-of-care (SOC) chemotherapy in adults with relapsed/unresponsive ALL in a phase 3 study.  

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a procedure in which a person receives blood-forming stem cells from a genetically similar, but not identical, donor. This is often a sister or brother but could also be an unrelated donor. 

It was unknown what the outcomes for patients with relapsed or unresponsive ALL who underwent allo-HSCT after blinatumomab would be.  

This study involved 97 patients with relapsed or unresponsive ALL and underwent allo-HSCT after treatment with blinatumomab. In a previous study, patients were split into two groups. 65 patients received blinatumomab and 32 received SOC. These patients then went on to receive allo-HSCT.   

There was no difference in survival after HSCT between the blinatumomab group and the SOC group.  

There was no difference in survival in patients who achieved a complete remission with full, partial or incomplete hematologic recovery with blinatumomab who received HSCT compared to those who did not receive HSCT.  

Patients with no prior salvage therapy and minimal residual disease (MRD – small traces of cancer left) response to blinatumomab had the best outcomes regardless of HSCT status.  

This study concluded that survival was driven by the response to study treatment and by salvage status, regardless of transplant status. 

The patients in this study were not randomly assigned to a treatment group. This might have affected the results. More studies are needed.

This study was funded by Amgen, the manufacturer of blinatumomab.