Efficacy of blinatumomab as a bridge therapy for allogeneic hematopoietic stem cell transplantation in treatment of minimal residual disease-positive B-lineage acute lymphoblastic leukemia

Liu Jia; Zhu Lidan; Gao Shichun; Liu Huanfeng; Wang Lu; Zhang Cheng; Gao Li; Zhang Xi; Kong Peiyan; Gao Lei

doi:10.13406/j.cnki.cyxb.003939

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Efficacy of blinatumomab as a bridge therapy for allogeneic hematopoietic stem cell transplantation in treatment of minimal residual disease-positive B-lineage acute lymphoblastic leukemia

Clinical research | 更新时间：2025-10-21

- Efficacy of blinatumomab as a bridge therapy for allogeneic hematopoietic stem cell transplantation in treatment of minimal residual disease-positive B-lineage acute lymphoblastic leukemia
- Journal of Chongqing Medical University Vol. 50, Issue 10, Pages: 1453-1456(2025)
- 作者机构：
  
  1.陆军军医大学第二附属医院血液病医学中心，重庆 400037
  2.陆军军医大学第二附属医院金凤实验室，重庆 401329
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003939
  CLC： R457.7
- Received：17 February 2025，
  
  Revised：2025-07-01，
  
  Accepted：15 July 2025，
  
  Published：28 October 2025
- 稿件说明：
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刘嘉,朱丽丹,高世春,等.贝林妥欧单抗桥接异基因造血干细胞移植治疗微小残留病阳性急性B淋巴细胞白血病疗效分析[J].重庆医科大学学报,2025,50(10):1453-1456.

Liu Jia,Zhu Lidan,Gao Shichun,et al.Efficacy of blinatumomab as a bridge therapy for allogeneic hematopoietic stem cell transplantation in treatment of minimal residual disease-positive B-lineage acute lymphoblastic leukemia[J].Journal of Chongqing Medical University,2025,50(10):1453-1456.
刘嘉,朱丽丹,高世春,等.贝林妥欧单抗桥接异基因造血干细胞移植治疗微小残留病阳性急性B淋巴细胞白血病疗效分析[J].重庆医科大学学报,2025,50(10):1453-1456. DOI： 10.13406/j.cnki.cyxb.003939.

Liu Jia,Zhu Lidan,Gao Shichun,et al.Efficacy of blinatumomab as a bridge therapy for allogeneic hematopoietic stem cell transplantation in treatment of minimal residual disease-positive B-lineage acute lymphoblastic leukemia[J].Journal of Chongqing Medical University,2025,50(10):1453-1456. DOI： 10.13406/j.cnki.cyxb.003939.

摘要

目的

探索有效治疗策略，以降低异基因造血干细胞移植（allogeneic hematopoietic stem cell transplantation，allo-HSCT）前微小残留病（minimal residual disease，MRD）阳性急性B淋巴细胞白血病（acute B-cell lymphocyte leukemia，B-ALL）患者移植后高复发风险。

方法

回顾性分析陆军军医大学第二附属医院血液病医学中心2022年11月至2024年11月10例移植前MRD阳性B-ALL患者，中位年龄30（7~56）岁，男4例，女6例，4例无关供者移植，6例亲缘间单倍体移植。10例患者均给予贝林妥欧单抗（≥45 kg，28 µg/d，14 d；

45 kg，5 µg/m

/d，14 d），7 d之内桥接异基因造血干细胞移植预处理。

结果

10例患者经贝林妥欧单抗治疗后MRD均转阴，造血干细胞移植后100%供者造血重建，中性粒细胞重建中位时间12（9~22）d，血小板重建中位时间13.5（9~22）d。至2025年1月，中位观察时间14（2~26）个月，2例复发，1例MRD转阳，复发率20%；9例存活，1例死于疾病复发，1例复发后经Car T细胞治疗再次达到完全缓解，MRD转阳患者经白细胞介素-2（interleukin-2，IL-2）治疗MRD再次转阴，目前均存活。治疗期间，有1例患者并发细胞因子释放综合征，1例患者并发新冠病毒感染，1例患者并发带状疱疹及病毒性脑炎，3例患者出现Ⅰ~Ⅱ度急性移植物抗宿主病，4例出现慢性移植物抗宿主病，无移植相关微血栓病变发生。

结论

贝林妥欧单抗桥接异基因造血干细胞移植治疗MRD阳性B-ALL可明显降低移植后复发、并发症较少且易控制，后续可通过多中心、随机对照临床研究进一步验证其有效性和安全性。

Abstract

Objective

To investigate effective strategies to reduce the high risk of recurrence after allogeneic hematopoietic stem cell transplantation（allo-HSCT） in patients with minimal residual disease（MRD）-positive B-lineage acute lymphoblastic leukemia（B-ALL）.

Methods

A retrospective analysis was performed for ten B-ALL patients with positive MRD before transplantation at our center from November 2022 to November 2024. There were four male patients and six female patients，with a median age of 30（7-56） years. Of all patients，four received transplantation from unrelated donors，and six received haploidentical transplantation from relatives. All ten patients received blinatumomab（28 µg/day for 14 days for patients ≥45 kg； 5 µg/m²/day for 14 days for patients <45 kg） and were bridged to the conditioning regimen for allo-HSCT within 7 days.

Results

After treatment with blinatumomab，all ten patients achieved the clearance of MRD. After allo-HSCT，100% of the patients achieved donor hematopoietic reconstitution. The median time to neutrophil reconstitution was 12（9-22） days，and the median time to platelet reconstitution was 13.5（9-22） days. As of January 2025，the median observation time was 14（2-26） months； of all patients，two experienced recurrence，and one had positive MRD again，with a recurrence rate of 20%. Among the ten patients，nine survived and one died of disease recurrence. One patient achieved complete remission again after chimeric antigen receptor T-cell（CAR-T） therapy following recurrence，and the patient with positive MRD achieved the clearance of MRD again after interleukin-2 treatment； both patients were currently alive. During treatment，one patient developed cytokine release syndrome，one patient was comorbid with SARS-CoV-2 infection，one patient had herpes zoster and viral encephalitis，three patients developed grade Ⅰ-Ⅱ acute graft-versus-host disease，and four patients developed chronic graft-versus-host disease； no transplantation-associated thrombotic microangiopathy was observed.

Conclusion

For patients with MRD-positive B-ALL，blinatumomab as a bridge therapy for allo-HSCT can significantly reduce recurrence after transplantation，with fewer complications that are easy to control. Multicenter randomized controlled clinical studies can be performed to further verify its efficacy and safety.

关键词

Keywords

references

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