Successful Long-Term Remission in Infantile Acute Leukemia Treated With Chemotherapy and Blinatumomab: A Case Report

BACKGROUND Blinatumomab is a novel targeted therapy for acute lymphoblastic leukemia that is currently used to treat patients with relapsed or refractory B-cell acute lymphoblastic leukemia (B-ALL). There are relatively few reports on the use of blinatumomab in infants after initial diagnosis. We report a case of B-ALL in an infant who was treated with blinatumomab and achieved favorable long-term prognosis, without serious adverse reactions occurring during treatment. This case provides a promising treatment option for infant patients. CASE REPORT This report describes the case of an infant who presented with lethargy and skin petechiae. Laboratory analysis revealed markedly elevated white blood cell counts, and a bone marrow examination confirmed the presence of ALL. Previous chemotherapy regimens for infants have often resulted in severe adverse reactions, including sepsis, severe anemia, bleeding, and wasting syndrome. In this case, the treatment plan was amended to incorporate blinatumomab in addition to chemotherapy, which resulted in long-term survival. During treatment, the patient experienced adverse reactions, including fever, infection, and elevated transaminases. Nevertheless, the patient tolerated the drug regimen well, suggesting that it could be a promising therapeutic option for infants with leukemia. CONCLUSIONS Blinatumomab has shown promise as a safe and effective treatment for infant leukemia. When administered during the induction phase, it may help induce remission of the disease and reduce the risk of adverse drug reactions, compared with chemotherapy. Using blinatumomab in combination with reduced-intensity chemotherapy during the maintenance phase may help sustain long-term disease remission in infant patients.