Outcomes for Australian children with relapsed/refractory acute lymphoblastic leukaemia treated with blinatumomab

Rosemary Sutton; Luciano Dalla Pozza; Seong Lin Khaw; Chris Fraser; Tom Revesz; Janis Chamberlain; Richard Mitchell; Toby N Trahair; Caroline M Bateman; Nicola C Venn; Tamara Law; Erika Ong; Susan L Heatley; Barbara J McClure; Claus Meyer; Rolf Marschalek; Michelle J Henderson; Siobhan Cross; Deborah L White; Rishi S Kotecha

doi:10.1002/pbc.28922

Outcomes for Australian children with relapsed/refractory acute lymphoblastic leukaemia treated with blinatumomab

Pediatr Blood Cancer. 2021 May;68(5):e28922. doi: 10.1002/pbc.28922. Epub 2021 Feb 26.

Authors

Rosemary Sutton^{1

2}, Luciano Dalla Pozza³, Seong Lin Khaw⁴, Chris Fraser⁵, Tom Revesz^{6

7}, Janis Chamberlain⁸, Richard Mitchell^{2

9}, Toby N Trahair^{1

2

9}, Caroline M Bateman³, Nicola C Venn¹, Tamara Law¹, Erika Ong¹, Susan L Heatley^{7

10}, Barbara J McClure^{7

10}, Claus Meyer¹¹, Rolf Marschalek¹¹, Michelle J Henderson^{1

2}, Siobhan Cross¹², Deborah L White^{7

10

13}, Rishi S Kotecha^{14

15

16}

Affiliations

¹ Molecular Diagnostics, Children's Cancer Institute, Sydney, New South Wales, Australia.
² School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
³ Cancer Centre for Children, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
⁴ Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia.
⁵ Blood and Bone Marrow Transplant Program, Queensland Children's Hospital, Brisbane, Queensland, Australia.
⁶ Department of Clinical Haematology and Oncology, Women's and Children's Hospital, Adelaide, South Australia, Australia.
⁷ University of Adelaide, Adelaide, South Australia, Australia.
⁸ John Hunter Children's Hospital, Newcastle, New South Wales, Australia.
⁹ Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.
¹⁰ Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
¹¹ Institute of Pharmaceutical Biology/Diagnostic Center of Acute Leukemia, Goethe University, Frankfurt, Germany.
¹² Children's Haematology/Oncology Centre, Christchurch Hospital, Christchurch, New Zealand.
¹³ Australian Genomics Health Alliance, Parkville, Melbourne, Victoria, Australia.
¹⁴ Department of Clinical Haematology, Oncology and Bone Marrow Transplantation, Perth Children's Hospital, Perth, Western Australia, Australia.
¹⁵ Telethon Kids Cancer Centre, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
¹⁶ School of Pharmacy and Biomedical Sciences, Curtin University, Perth, Western Australia, Australia.

PMID: 33638292
DOI: 10.1002/pbc.28922

Abstract

We report on the Australian experience of blinatumomab for treatment of 24 children with relapsed/refractory precursor B-cell acute lymphoblastic leukaemia (B-ALL) and high-risk genetics, resulting in a minimal residual disease (MRD) response rate of 58%, 2-year progression-free survival (PFS) of 39% and 2-year overall survival of 63%. In total, 83% (n = 20/24) proceeded to haematopoietic stem cell transplant, directly after blinatumomab (n = 12) or following additional salvage therapy (n = 8). Four patients successfully received CD19-directed chimeric antigen receptor T-cell therapy despite prior blinatumomab exposure. Inferior 2-year PFS was associated with MRD positivity (20%, n = 15) and in KMT2A-rearranged infants (15%, n = 9). Our findings highlight that not all children with relapsed/refractory B-ALL respond to blinatumomab and factors such as blast genotype may affect prognosis.

Keywords: acute lymphoblastic leukaemia; blinatumomab; paediatric; refractory; relapse.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antibodies, Bispecific / therapeutic use*
Antineoplastic Agents / therapeutic use*
Australia
Child
Female
Humans
Male
Neoplasm Recurrence, Local / drug therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology
Retrospective Studies
Treatment Outcome

Substances

Antibodies, Bispecific
Antineoplastic Agents
blinatumomab