Department of Hematology, Hôpital Saint-Louis (Assistance Publique - Hôpitaux de Paris) and University Paris Diderot , Paris , France.
Klinik und Poliklinik II, Universitätsklinikum Würzburg , Würzburg , Germany.
Leuk Lymphoma. 2019 Sep;60(9):2214-2222. doi: 10.1080/10428194.2019.1576872. Epub 2019 Apr 5.
Outcomes for adults with relapsed/refractory acute lymphoblastic leukemia (ALL) are poor with chemotherapy, particularly in later salvage. The TOWER study examined survival, remission, bridge to allogeneic hematopoietic stem cell transplantation (HSCT), and safety with blinatumomab versus chemotherapy. This report examined outcomes separately for study treatment as first or later salvage. Adults with Philadelphia chromosome-negative B-cell precursor ALL relapsed/refractory to chemotherapy were randomly assigned 2:1 to receive blinatumomab by continuous infusion for 4 weeks in 6-week cycles, or standard salvage chemotherapy. Overall survival for blinatumomab versus chemotherapy was higher both in first salvage and in later salvage. Safety was similar between patients in first salvage and those in later salvage. Blinatumomab as later salvage was associated with higher complete remission rates and served as a bridge to allogeneic HSCT, supporting the use of blinatumomab in both settings. This study is registered at www.clinicaltrials.gov as #NCT02013167.
复发/难治性急性淋巴细胞白血病 (ALL) 成人患者的预后较差，化疗效果尤其不佳，尤其是在晚期挽救性治疗中。TOWER 研究评估了blinatumomab 与化疗相比在挽救性治疗中的生存、缓解、桥接异基因造血干细胞移植 (HSCT) 和安全性。本报告分别评估了研究治疗作为一线或二线挽救性治疗的结果。费城染色体阴性 B 细胞前体 ALL 化疗复发/难治的成人患者按 2:1 随机分配，接受blinatumomab 持续输注 4 周，每 6 周为一个周期，或接受标准挽救性化疗。blinatumomab 与化疗相比，在一线挽救性治疗和二线挽救性治疗中均有更高的总生存率。一线挽救性治疗和二线挽救性治疗患者的安全性相似。blinatumomab 作为二线挽救性治疗与更高的完全缓解率相关，并可桥接异基因 HSCT，支持在这两种情况下使用 blinatumomab。该研究在 www.clinicaltrials.gov 上注册为 #NCT02013167。
