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Low leukemia burden improves blinatumomab efficacy in patients with relapsed/refractory B‐cell acute lymphoblastic leukemia.
- Source :
-
Cancer (0008543X) . May2023, Vol. 129 Issue 9, p1384-1393. 10p. - Publication Year :
- 2023
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Abstract
- Background: A lower baseline bone marrow blast percentage (bBMB%) is associated with better outcomes in patients with B‐cell acute lymphoblastic leukemia (B‐ALL) receiving blinatumomab. The objective of this analysis was to investigate the association between bBMB% and treatment outcomes in relapsed/refractory (R/R) B‐ALL. Methods: Data from five trials of blinatumomab for R/R B‐ALL were pooled for analyses. Patients were placed in one of three groups: group 1, ≥50% bBMBs; group 2, ≥25% to <50% bBMBs; group 3, ≥5% to <25% bBMBs. Response and survival outcomes were compared between groups. Results: Data from 683 patients (166 pediatric, 517 adult) were analyzed. Collectively, patients in groups 2 and 3 had significantly higher odds of achieving a complete remission (CR) (odds ratio [OR], 3.50 [95% confidence interval (CI), 2.23–5.48] and 3.93 [95% CI, 2.50–6.18], respectively; p <.001) and minimal/measurable residual disease response (OR, 2.61 and 3.37, respectively; p <.001) when compared with group 1 (reference). Groups 2 and 3 had a 37% and 46% reduction in the risk of death (hazard ratio [HR], 0.63 and 0.54, respectively; p <.001) and a 41% and 43% reduction in the risk of an event (relapse or death) (HR, 0.59 and 0.57, respectively; p <.001) compared with group 1. No significant differences in response or survival outcomes were observed between groups 2 and 3. Seven of nine patients whose bBMB% was lowered to <50% with dexamethasone achieved CR with blinatumomab. Conclusion: Any bBMB% <50% was associated with improved efficacy following blinatumomab treatment for R/R B‐ALL. Patients with a baseline leukemia burden of <50% bone marrow blasts achieved better outcomes with blinatumomab compared with those who had ≥50% blasts. There was no statistical difference in clinical outcomes with blinatumomab in patients who had ≥5% to <50% bone marrow blasts at baseline. [ABSTRACT FROM AUTHOR]
- Subjects :
- *LYMPHOBLASTIC leukemia
*ACUTE leukemia
*LEUKEMIA
*BONE marrow
*SURVIVAL rate
Subjects
Details
- Language :
- English
- ISSN :
- 0008543X
- Volume :
- 129
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- Cancer (0008543X)
- Publication Type :
- Academic Journal
- Accession number :
- 162971514
- Full Text :
- https://doi.org/10.1002/cncr.34667