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.