Blinatumomab-based salvage in relapsed/refractory B-cell acute lymphoblastic leukemia: "real world" experience from a single-centre in India

Blinatumomab is efficacious in achieving disease remission in children with CD-19 positive relapsed/refractory (R/R) B-lineage acute lymphoblastic leukemia (B-ALL). Blinatumomab was administered to 9 patients with R/R B-ALL, of which 8 (88%) were not in remission post-salvage chemotherapy. Seven (87.5%) of eight patients attained morphological remission, and 5/8 (62.5%) had measurable residual disease response following the 1 st cycle. Three received 2 nd cycle; 2 were non-responsive, and 1 had progressive disease during infusion. Cytokine release syndrome Grade 3 was seen in 2/9 (22%) patients. Seven (78%) underwent hematopoietic stem cell transplant. At a median follow-up of 650 days, the overall survival and progression-free survival of the cohort was 55.6%(±16.6). Our case series emphasizes the feasibility and ease of administration of blinatumomab with minimal toxicity and efficacy similar to international standards in a resource-limited setting.