Relapsed or resistant B-cell precursor acute lymphoblastic leukemia (r/r B ALL) in adult patients has a poor prognosis. Complete remission rates after the first relapse with standard multiple chemotherapy have been reported to be 40-50%. After the second relapse, CR rate in below 20%. New immunotherapeutic agents applied in recent years have demonstrated high rates of complete remission and a safe bridging role to allogeneic stem cell transplantation (allo-HCT). Blinatumomab is a CD19/CD3 bispecific T cell antibody that enables CD3-positive T cells to recognize CD19. Inotuzumab ozogamicin is an antibody-calicheamicin conjugate that targets CD22 in B-ALL cells. These agents act as a bridge to allo-HCT, with overall response rates of up to 80% and negative measurable residual disease (MRD). In BMT unit, blinatumomab in 4 patients and inotuzumab ozogamycin in 6 patients were given as a bridge to allogeneic transplantation in B-ALL patients. Complete remission was achieved in 2 patients who were given blinatumomab, and they were followed by BMT; On patient died due to the neurological side effects of the blinatumomab; One patient could not tolerate the other side effects and blinatumomab was discontinued. Complete remission was achieved in 4 patients had given inotuzumab ozogamicin and allogeneic stem cell transplantation was performed; One patient could not tolerate inotuzumab because of cardiac side effects and inotuzumab was discontinued; Complete remission was not achieved in 1 patient who had given inotuzumab. Blinatumomab treatment requires good follow-up, especially in terms of cytokine release syndrome (CRS) and neurological side effects. In conclusion, both inotuzumab ozogamicin and blinatumomab are successfully used as a bridge to allogeneic stem cell transplantation in B-ALL patients.

No relevant conflicts of interest to declare.

Author notes

*Asterisk with author names denotes non-ASH members.

© 2022 by The American Society of Hematology
2022
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