Outcome of patients with relapsed/refractory acute lymphoblastic leukemia after blinatumomab failure: No change in the level of CD19 expression

Elias Jabbour, Johannes Düll, Musa Yilmaz, Joseph D. Khoury, Farhad Ravandi, Nitin Jain, Hermann Einsele, Guillermo Garcia-Manero, Marina Konopleva, Nicholas J. Short, Philip A. Thompson, William Wierda, Naval Daver, Jorge Cortes, Susan O'brien, Hagop Kantarjian, Max S. Topp

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Blinatumomab, a bi-specific T-cell engaging CD3-CD19 antibody construct, has shown significant activity in patients with relapsed/refractory (R/R) B-cell acute lymphoblastic leukemia (ALL). Despite this improvement, most patients relapse. Here, we describe the outcome of 68 patients with R/R ALL after failure of blinatumomab therapy: 38 (56%) blinatumomab refractory; 30 (44%) relapsing after initial response. After a median follow-up of 49 months, 9 (13%) patients remained alive. The median overall survival after blinatumomab failure was 5.2 months. At the time of failure, among 61 patients evaluated for immunophenotype, 56 (92%) had CD19-positive blasts; only five (8%) had ALL recurrence with CD19-negative disease. Two patients progressed with lower CD19 expression. In summary, the outcome of patients with R/R ALL after blinatumomab failure is poor and treatment of these patients remains an unmet medical need. Our findings indicate that blinatumomab therapy would not exclude a significant number of patients from the potential benefit of subsequent CD19-directed therapies such as chimeric antigen receptor T-cell therapy.

Original languageEnglish (US)
Pages (from-to)371-374
Number of pages4
JournalAmerican Journal of Hematology
Volume93
Issue number3
DOIs
StatePublished - Mar 2018
Externally publishedYes

ASJC Scopus subject areas

  • Hematology

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    Jabbour, E., Düll, J., Yilmaz, M., Khoury, J. D., Ravandi, F., Jain, N., Einsele, H., Garcia-Manero, G., Konopleva, M., Short, N. J., Thompson, P. A., Wierda, W., Daver, N., Cortes, J., O'brien, S., Kantarjian, H., & Topp, M. S. (2018). Outcome of patients with relapsed/refractory acute lymphoblastic leukemia after blinatumomab failure: No change in the level of CD19 expression. American Journal of Hematology, 93(3), 371-374. https://doi.org/10.1002/ajh.24987