Antigen-based immunotherapy for the treatment of acute lymphoblastic leukemia: the emerging role of blinatumomab
- PMID: 27471701
- PMCID: PMC4918236
- DOI: 10.2147/ITT.S37292
Antigen-based immunotherapy for the treatment of acute lymphoblastic leukemia: the emerging role of blinatumomab
Abstract
Acute lymphoblastic leukemia (ALL) arises from immature B and T lymphoblasts. An increasing array of cytogenetic and molecular markers have been identified in ALL, which allows for increasingly sophisticated prognostication, as well as identification of potential new targets for therapy. The treatment of ALL in children has shown astounding success in the last 50 years, with more than 90% of children now able to be cured of their ALL. In adults, these success rates have not been duplicated. However, the use of pediatric-intensive regimens in young adults has shown increasing success. The use of monoclonal antibodies conjugated to drugs, immunotoxins, and cells also has shown early success and promises to enhance the outcome of newly diagnosed patients. Blinatumomab, a bispecific T-cell engager antibody, brings a malignant B cell in proximity to a T cell with redirected lysis. This antibody construct has shown promising results in patients with relapsed and refractory disease and is entering randomized clinical trials in newly diagnosed patients. The addition of monoclonal antibody therapy to chemotherapy in adults promises to enhance outcomes while hopefully not increasing toxicity. After many years of stagnation, it appears that the therapy of adults with ALL is showing significant improvement.
Keywords: CD19; acute lymphoblastic leukemia; blinatumomab; chemotherapy; monoclonal antibodies.
Figures




Similar articles
-
Efficacy and safety of bispecific T-cell engager blinatumomab and the potential to improve leukemia-free survival in B-cell acute lymphoblastic leukemia.Expert Rev Hematol. 2017 Dec;10(12):1057-1067. doi: 10.1080/17474086.2017.1396890. Epub 2017 Nov 1. Expert Rev Hematol. 2017. PMID: 29082835 Review.
-
Monoclonal antibody-based therapies in the treatment of acute lymphoblastic leukemia.Am Soc Clin Oncol Educ Book. 2013:294-9. doi: 10.14694/EdBook_AM.2013.33.294. Am Soc Clin Oncol Educ Book. 2013. PMID: 23714527 Review.
-
Extramedullary relapse and discordant CD19 expression between bone marrow and extramedullary sites in relapsed acute lymphoblastic leukemia after blinatumomab treatment.Curr Probl Cancer. 2019 Jun;43(3):222-227. doi: 10.1016/j.currproblcancer.2018.04.006. Epub 2018 May 7. Curr Probl Cancer. 2019. PMID: 29895435
-
Blinatumomab: A First-in-Class Bispecific T-Cell Engager for Precursor B-Cell Acute Lymphoblastic Leukemia.Ann Pharmacother. 2015 Sep;49(9):1057-67. doi: 10.1177/1060028015588555. Epub 2015 Jun 3. Ann Pharmacother. 2015. PMID: 26041811 Review.
-
Profile of blinatumomab and its potential in the treatment of relapsed/refractory acute lymphoblastic leukemia.Onco Targets Ther. 2015 Jun 24;8:1567-74. doi: 10.2147/OTT.S70524. eCollection 2015. Onco Targets Ther. 2015. PMID: 26170691 Free PMC article. Review.
Cited by
-
Acute Lymphoblastic Leukemia Immunotherapy Treatment: Now, Next, and Beyond.Cancers (Basel). 2023 Jun 26;15(13):3346. doi: 10.3390/cancers15133346. Cancers (Basel). 2023. PMID: 37444456 Free PMC article. Review.
-
The pharmacology of blinatumomab: state of the art on pharmacodynamics, pharmacokinetics, adverse drug reactions and evaluation in clinical trials.J Clin Pharm Ther. 2022 Sep;47(9):1337-1351. doi: 10.1111/jcpt.13741. Epub 2022 Jul 29. J Clin Pharm Ther. 2022. PMID: 35906791 Free PMC article. Review.
References
-
- Gutierrez A, Armstrong SA, Look AT. Pathobiology of acute lymphoblastic leukemia. In: Hoffman R, Benz EJJ, Silberstein LE, Heslop HE, Weitz JI, Anastasi J, editors. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2013. pp. 935–950.
-
- Pui CH, Behm FG, Crist WM. Clinical and biologic relevance of immunologic marker studies in childhood acute lymphoblastic leukemia. Blood. 1993;82(2):343–362. - PubMed
-
- Pui CH, Behm FG, Singh B, et al. Myeloid-associated antigen expression lacks prognostic value in childhood acute lymphoblastic leukemia treated with intensive multiagent chemotherapy. Blood. 1990;75(1):198–202. - PubMed
-
- Moorman AV, Harrison CJ, Buck GA, et al. Adult Leukaemia Working Party, Medical Research Council/National Cancer Research Institute Karyotype is an independent prognostic factor in adult acute lymphoblastic leukemia (ALL): analysis of cytogenetic data from patients treated on the Medical Research Council (MRC) UKALLXII/Eastern Cooperative Oncology Group (ECOG) 2993 trial. Blood. 2007;109(8):3189–3197. - PubMed
Publication types
LinkOut - more resources
Full Text Sources
Other Literature Sources