Queudeville Manon, Ebinger Martin
Department I-General Pediatrics, Hematology/Oncology, Children's Hospital, University Hospital Tübingen, 72076 Tübingen, Germany.
J Clin Med. 2021 Jun 8;10(12):2544. doi: 10.3390/jcm10122544.
Acute lymphoblastic leukemia is by far the most common malignancy in children, and new immunotherapeutic approaches will clearly change the way we treat our patients in future years. Blinatumomab is a bispecific T-cell-engaging antibody indicated for the treatment of relapsed/refractory acute lymphoblastic leukemia (R/R-ALL). The use of blinatumomab in R/R ALL has shown promising effects, especially as a bridging tool to hematopoietic stem cell transplantation. For heavily pretreated patients, the response to one or two cycles of blinatumomab ranges from 34% to 66%. Two randomized controlled trials have very recently demonstrated an improved reduction in minimal residual disease as well as an increased survival for patients treated with blinatumomab compared to standard consolidation treatment in first relapse. Current trials using blinatumomab frontline for high-risk patients or as a consolidation treatment post-transplant will show whether efficacy is even higher in less heavily pretreated patients. Due to the distinct pattern of adverse events compared to high-dose conventional chemotherapy, blinatumomab could play an important role for patients with a risk for severe chemotherapy-associated toxicities. This systematic review discusses all published results for blinatumomab in children as well as all ongoing clinical trials.
急性淋巴细胞白血病是目前儿童中最常见的恶性肿瘤，新的免疫治疗方法无疑将在未来几年改变我们治疗患者的方式。博纳吐单抗是一种双特异性T细胞衔接抗体，用于治疗复发/难治性急性淋巴细胞白血病（R/R-ALL）。博纳吐单抗在R/R ALL中的应用已显示出有前景的效果，尤其是作为造血干细胞移植的桥接工具。对于经过大量预处理的患者，接受一或两个周期博纳吐单抗治疗的缓解率在34%至66%之间。最近的两项随机对照试验表明，与首次复发时的标准巩固治疗相比，接受博纳吐单抗治疗的患者在最小残留病的减少以及生存率提高方面有改善。目前使用博纳吐单抗一线治疗高危患者或作为移植后巩固治疗的试验将表明，在预处理程度较轻的患者中疗效是否更高。由于与高剂量传统化疗相比，不良事件的模式不同，博纳吐单抗对于有严重化疗相关毒性风险的患者可能发挥重要作用。本系统评价讨论了已发表的关于博纳吐单抗在儿童中的所有结果以及所有正在进行的临床试验。
