Blinatumomab added to conditioning regimen of allogeneic hematopoietic stem cell transplantation for adult MRD - positive acute lymphoblastic leukemia: a single-center case series

Hematology. 2025 Dec;30(1):2439605. doi: 10.1080/16078454.2024.2439605. Epub 2025 Jan 8.

Abstract

Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) remains the mainstay of treatment for adults with high-risk acute lymphoblastic leukemia (ALL). Due to the crucial role of measurable residual disease (MRD) before Allo-HSCT in predicting relapse and the promising anti-leukemia effect of blinatumomab, we documented a short-course, low-dose conditioning regimen incorporating blinatumomab for Allo-HSCT in three ALL patients with positive MRD. Following the administration of the blinatumomab-containing conditioning regimen, all patients attained complete remission (CR) with negative MRD status, and no severe adverse events were observed. After a 2-year follow-up, 2/3 of patients remained disease-free and attained long-term survival following transplantation. These cases indicated a short-term blinatumomab conditioning regimen may effectively prolong patient survival, improve prognosis, and offer a safe and cost-effective treatment for high-risk ALL patients with positive MRD. The addition of blinatumomab to the conditioning regimen of Allo-HSCT is feasible for high-risk ALL patients with positive MRD.

Keywords: Adult Single-center Case series; Blinatumomab; MRD-positive; acute lymphoblastic leukemia; adult; allo-HSCT; case series; conditioning regimen; single-center.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Bispecific* / administration & dosage
  • Antibodies, Bispecific* / therapeutic use
  • Female
  • Hematopoietic Stem Cell Transplantation* / methods
  • Humans
  • Male
  • Middle Aged
  • Neoplasm, Residual*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / therapy
  • Transplantation Conditioning* / methods
  • Transplantation, Homologous

Substances

  • Antibodies, Bispecific
  • blinatumomab