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In children with a late, low-risk relapse of leukaemia, adding three blocks of blinatumomab did not change survival overall, but for the two thirds whose relapse involved the bone marrow it cut relapses and deaths enough to become their new standard.
Report of the low-risk stratum of the Children's Oncology Group AALL1331 trial: 255 patients aged 1 to 30 with low-risk first relapse of B-cell acute lymphoblastic leukaemia were randomised after reinduction to standard chemotherapy or chemotherapy with three blinatumomab blocks intercalated.
Four-year disease-free and overall survival were 61.2 and 90.4 percent with blinatumomab against 49.5 and 79.6 percent with chemotherapy (p 0.089 and 0.11). For the 174 patients with bone marrow relapse (with or without extramedullary disease) the differences were significant (disease-free survival 72.7 against 53.7 percent, overall survival 97.1 against 84.8 percent), while the 81 patients with isolated extramedullary relapse did poorly in both arms.
Blinatumomab belongs in the treatment of low-risk marrow relapse in children; isolated extramedullary relapse needs new approaches.
Shares AALL1331, Relapsed and refractory acute lymphoblastic leukaemia in children, Blinatumomab, Acute lymphoblastic leukaemia.
Shares Relapsed and refractory acute lymphoblastic leukaemia in children, Blinatumomab, Acute lymphoblastic leukaemia.
Shares Relapsed and refractory acute lymphoblastic leukaemia in children, Blinatumomab, Acute lymphoblastic leukaemia.
Shares Relapsed and refractory acute lymphoblastic leukaemia in children, Acute lymphoblastic leukaemia.
Shares Relapsed and refractory acute lymphoblastic leukaemia in children, Acute lymphoblastic leukaemia.
Shares Relapsed and refractory acute lymphoblastic leukaemia in children, Blinatumomab, Acute lymphoblastic leukaemia.
Shares Relapsed and refractory acute lymphoblastic leukaemia in children, Acute lymphoblastic leukaemia.