The addition of blinatumomab to prephase, consolidation, and after intensification in patients with B-ALL: updated results from the HOVON-146 trial

In the prephase, blinatumomab led to early response rates: the CR and MRD-negativity rates were 63% and 53%, respectively.  

After a median follow-up of 43 months, the event-free survival (EFS) rates in patients aged ≤40 years and >40 years were 64% and 40%, respectively, and the overall survival (OS) rates were 86% and 50%, respectively.  

In Philadelphia-positive (Ph+) patients and Philadelphia-negative patients, the EFS rates were 75% and 64%, respectively, and the OS rates were 85% and 70%. 

When results were compared with the HOVON-100 trial, the addition of blinatumomab to chemotherapy improved outcomes, particularly for patients aged >40 years and Ph+ patients.  

Substantial toxicity was observed in patients aged >60 years; however, after chemotherapy dose adaptations there were no further safety concerns.  

Further studies are warranted to assess the substitution of chemotherapy for blinatumomab, particularly for Ph+ and elderly patients, to potentially reduce toxicity and improve outcomes.