Immunoglobulin Depletion and Recovery Following Blinatumomab in Infants With KMT2A‐Rearranged ALL
Adding blinatumomab to standard chemotherapy for infants with KMT2A-rearranged acute B-cell lymphoblastic leukemia (KMT2A-r B-ALL) improves outcomes. Although blinatumomab impairs immunoglobulin G (lgG) production, increasing infection susceptibility, IgG recovery remains poorly understood. Thirty infants received Interfant-06 protocol chemotherapy with one course of blinatumomab added post-induction. We screened 169 IgG levels post-blinatumomab and IVIg supplementation timepoints. An increase in IgG was subsequently noted until maintenance, where practically all available values returned to normal (>4 g/L). Blinatumomab leads to an IgG reduction, with near-complete recovery occurring before end of treatment. Future trials should monitor immunoglobulin recovery post-blinatumomab to guide infection-preventing strategies. Trial Registration: EudraCT no: 2016-004674-17.
Authors
- Rishi S. Kotecha (ORCID: https://orcid.org/0000-0003-1836-4075)
- Peggy E. Scholte-van Houtem
- Inge M. van der Sluis (ORCID: https://orcid.org/0000-0002-5822-7668)
- Alina Ferster (ORCID: https://orcid.org/0000-0002-9920-8359)
- Franco Locatelli (ORCID: https://orcid.org/0000-0002-7976-3654)
- Jan Starý (ORCID: https://orcid.org/0000-0002-6818-7743)
- Miguel Vieira Martins (ORCID: https://orcid.org/0000-0002-3021-2843)
- Karsten Nysom (ORCID: https://orcid.org/0000-0003-2935-0058)
- Paola De Lorenzo
- M Schrappe
- Maria G. Valsecchi
- A Attarbaschi
- Gabriele Escherich
- Rob Pieters
- Benoit Brethon
Institutions
- Universität Hamburg (DE)
- Curtin University (AU)
- Charles University (CZ)
- Princess Margaret Hospital for Children (AU)
- Copenhagen University Hospital (DK)
- Rigshospitalet (DK)
- Assistance Publique – Hôpitaux de Paris (FR)
- University Hospital in Motol (CZ)
- Childhood Leukemia Foundation (US)
- Queen Fabiola Children's University Hospital (BE)
- University Medical Center Hamburg-Eppendorf (DE)
- Azienda Ospedaliera San Gerardo (IT)
- University Hospital Schleswig-Holstein (DE)
- Bambino Gesù Children's Hospital (IT)
- St Anna Children's Hospital (AT)
- Hôpital Robert-Debré (FR)
- Princess Máxima Center (NL)
- ANZCHOG (AU)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- Leukemia and Lymphoma Society (US)
- University of Milano-Bicocca (IT)
- University of Lübeck (DE)
Publication Details
- Journal
- Pediatric Blood & Cancer
- Published
- 2026-07-24
- DOI
- https://doi.org/10.1002/1545-5017.70547
- Primary Topic
- Acute Lymphoblastic Leukemia research
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Amgen