Blinatumomab for the treatment of adult acute lymphoblastic leukemia

The marker CD19 is frequently expressed on the surface of malignant B cells including non-Hodgkin's lymphoma (NHL), chronic lymphocytic leukemia (CLL) and acute lymphoblastic leukemia (ALL), which makes it an attractive target for antineoplastic therapy (1). T cells are part of the immune surveillance system for malignant cells (2). Blinatumomab is a bispecific T cell engager (BiTE(®)) antibody that binds both CD3-positive T cells and CD19-positive B cells via its two variable antigen-binding domains. Once bound to both the T and B cell, blinatumomab induces T-cell activation and subsequently perforin-mediated malignant B-cell death. It has shown efficacy in ALL with minimal residual disease, relapsed/refractory ALL, and NHL in phase I and II clinical trials. With a favorable safely profile and promising results, blinatumomab was granted accelerated FDA approval to treat B-cell ALL in December 2014. Herein, we will review the most relevant data related to blinatumomab in ALL.