Dose-Dense Mini-Hyper-CVD, Inotuzumab Ozogamicin and Blinatumomab Achieves Rapid MRD-Negativity in Philadelphia Chromosome-Negative B-cell Acute Lymphoblastic Leukemia.
In: Clinical lymphoma, myeloma & leukemia, Jg. 24 (2024-04-01), Heft 4, S. e168-e173
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Zugriff:
Background: The combination of low-intensity chemotherapy and inotuzumab ozogamicin (INO), with sequential blinatumomab, is highly effective in older adults with newly diagnosed B-cell acute lymphoblastic leukemia (ALL) and in relapsed or refractory B-cell ALL. Earlier, "dose-dense" administration of blinatumomab could lead to earlier and deeper measurable residual disease (MRD) responses and better outcomes.
Patients and Methods: We performed a retrospective analysis of the safety and efficacy of a dose-dense regimen of mini-hyper-CVD (mini-hyperfractionated cyclophosphamide, vincristine, and dexamethasone alternating with mini-methotrexate and cytarabine), INO, and blinatumomab in patients with B-cell ALL.
Results: Twenty-one patients were treated (frontline, n = 9; MRD consolidation, n = 4; relapsed/refractory, n = 8). In the frontline cohort, all patients achieved CR/CRi and MRD negativity by flow cytometry at the end of cycle 1. Across the frontline and MRD consolidation cohorts, 10/11 patients (91%) achieved next-generation sequencing MRD negativity at a sensitivity of 10 -6 , including 6/10 evaluable patients (60%) who achieved next-generation sequencing MRD negativity after cycle 1. The CR/CRi rate in the relapsed/refractory cohort was 63%, and all responders achieved MRD negativity by flow cytometry at the end of cycle 1. The 1-year overall survival rate for the combined cohort of the frontline and MRD-positive patients was 83%. No new safety signals were observed with the dose-dense mini-hyper-CVD, INO, and blinatumomab regimen.
Conclusion: Dose-dense delivery of mini-hyper-CVD, INO, and blinatumomab was safe and resulted in rapid and deep MRD negativity in patients with B-cell ALL. This regimen is now being prospectively evaluated in both the frontline and relapsed/refractory settings.
Competing Interests: Disclosure N.J.S, E.J., and H.K. have received research funding and honoraria from Amgen and Pfizer Inc. The rest of the authors have no relevant conflicts to disclose.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
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Dose-Dense Mini-Hyper-CVD, Inotuzumab Ozogamicin and Blinatumomab Achieves Rapid MRD-Negativity in Philadelphia Chromosome-Negative B-cell Acute Lymphoblastic Leukemia.
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Autor/in / Beteiligte Person: | Short, NJ ; Jabbour, E ; Jamison, T ; Paul, S ; Cuglievan, B ; McCall, D ; Gibson, A ; Jain, N ; Haddad, FG ; Nasr, LF ; Marx, KR ; Rausch, C ; Savoy, JM ; Garris, R ; Ravandi, F ; Kantarjian, H |
Zeitschrift: | Clinical lymphoma, myeloma & leukemia, Jg. 24 (2024-04-01), Heft 4, S. e168-e173 |
Veröffentlichung: | 2011-: [New York] : Elsevier ; <i>Original Publication</i>: Dallas, Tex. : Cancer Media Group, 2024 |
Medientyp: | academicJournal |
ISSN: | 2152-2669 (electronic) |
DOI: | 10.1016/j.clml.2023.12.016 |
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