Efficacy and safety of blinatumomab combination therapy in high-risk B-cell acute lymphoblastic leukemia: A...

The present study aimed to evaluate the efficacy and safety of blinatumomab-based combination therapy for high-risk B-cell acute lymphoblastic leukemia (B-ALL). PubMed, Embase, Web of Science and the Cochrane Library were searched for clinical studies on blinatumomab. The primary endpoints were complete remission (CR), minimal residual disease (MRD) and complete molecular remission (CMR). The secondary endpoint was overall survival (OS). Safety outcomes included adverse events (AEs), cytokine release syndrome, neurological events and hematological toxicity. A total of 11 studies involving 402 patients were included. The pooled CR rate was 87% (95% CI, 78-95%), the MRD negativity rate was 81% (95% CI, 75-87%) and the CMR rate was 81% (95% CI, 69-92%). The 1-year OS rate was 91% (95% CI, 78-100%), the 2-year OS rate was 87% (95% CI, 71-100%) and the 3-year OS rate was 52% (95% CI, 36-66%). Regarding safety, 86% (95% CI, 77-96%) of patients experienced all-grade AEs. Grade ≥3 AEs were generally consistent with known safety profiles, with the most common events being neutropenia (38%; 95% CI, 0-84%), febrile neutropenia (26%; 95% CI, 10-43%), and hyperglycemia (21%; 95% CI, 5-36%). In conclusion, blinatumomab-based combination therapy is an effective treatment for high-risk B-ALL with manageable toxicity.