Blinatumomab plus hyper-CVAD: the prelude to a new era in acute lymphocytic leukaemia

Abstract

Blinatumomab, a CD19/CD3 bispecific T-cell engager active as monotherapy in relapsed or refractory B-cell acute lymphocytic leukaemia, was approved for adults with positive minimal residual disease (MRD) in Europe and the USA in 2018. Approval was granted on the basis of a single-arm, phase 2 study, in which 78% of included patients had an MRD-negative complete response and promising outcomes and acceptable toxicity were seen.1,2 Early experiences have also been encouraging with blinatumomab as first-line treatment of Philadelphia chromosome (Ph)-positive and Ph-negative acute lymphocytic leukaemia in older adults (aged >65 years)—a population that has previously had poor outcomes owing to adverse biology and poor tolerance to chemotherapy.