Blinatumomab for patients with CD19+ acute leukemias and preexisting comorbidities

Results from a single-center, retrospective, cohort study, evaluating blinatumomab efficacy and safety in patients with CD19+ acute leukemias who had baseline conditions that would have excluded them from clinical trials, were recently published in Leukemia Research by Claiborne et al.

Key data: Among 34 patients with comorbidities, including liver dysfunction, renal impairment, central nervous system (CNS) pathology, autoimmune disease, solid organ transplantation, or uncontrolled infection, 88% completed at least one cycle of blinatumomab. Overall response rate was 73.5%, and 1-year overall survival rates were 66.7%, 91.7%, and 22.2% in frontline, consolidation, and relapsed/refractory settings, respectively. The 60-day cumulative incidence of Grade ≥2 cytokine release syndrome and neurotoxicity were 23.5% and 20.8%, respectively.

Key learning: Blinatumomab was administered to patients with baseline conditions that would have led to clinical trial exclusion, with response rates and survival outcomes comparable to clinical trial populations and adverse events generally occurring at similar rates. These findings provide evidence to consider removing certain exclusion criteria from future blinatumomab studies, potentially allowing more patients to benefit from this therapy.