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Combining blinatumomab and donor lymphocyte infusion in B-ALL patients relapsing after allogeneic hematopoietic cell transplantation: a study of the SFGM-TC

Bone Marrow Transplantation volume 58, pages 72–79 (2023)Cite this article

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Abstract

Relapsed B-cell acute lymphoblastic leukemia (B-ALL) after allogeneic stem cell transplantation (allo-HCT) still represents a major concern with poor outcomes. The aim of this study is to compare the efficacy and safety of blinatumomab and donor lymphocyte infusion (DLI) versus blinatumomab alone in this setting. This is a multicenter retrospective study from centers of SFGM-TC. All transplanted patients who received blinatumomab salvage therapy were included. Patients who received DLI from 1 month before to 100 days after the starting of blinatumomab were included in the blina-DLI group. Seventy-two patients were included. Medium follow-up was 38 months. Fifty received blinatumomab alone and 22 the association blinatumomab-DLI. Two-year overall survival (OS) was 31% in the blinatumomab group and 43% in the blinatumomab-DLI group (p = 0.31). Studying DLI as a time dependent variable, PFS did not significantly differ between the 2 groups (HR:0.7, 95% CI: 0.4–1.5). In multivariate analysis, DLI was not a prognostic factor for OS, progression-free survival and progression/relapse incidence. Adverse events and graft-versus-disease rates were comparable in the 2 groups. In conclusion, adding DLI between 1 month before and 100 days after start of blinatumomab is safe and does not seem to improve outcomes in B-ALL patients who relapsed after allo-HCT.

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Fig. 1: Landmark analysis of overall survival.

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Acknowledgements

We would like to thank SFGM-TC for scientific support, the medical team in each investigator center for their contributions and all the patients for their participation.

Author information

Authors and Affiliations

  1. CHU de Lille, Maladies du Sang, Université de Lille, 59000, Lille, France

    Paul Chauvet & Ibrahim Yakoub-Agha

  2. Sorbonne University, INSERM UMR-S 938, Saint-Antoine Research Centre, AP-PH, Department of Clinical Hematology and Cellular Therapy, Saint-Antoine Hospital, Paris, France

    Annalisa Paviglianiti, Myriam Labopin & Eolia Brissot

  3. Institut Català d’Oncologia, Cell Transplant/Cell Therapy Unit, Barcelona, Spain

    Annalisa Paviglianiti

  4. Hospices Civils de Lyon, Lyon-Sud Hospital, Clinical Hematology, Pierre-Bénite, France

    Hélène Labussière

  5. Université de Paris Cité, Institut de Recherche Saint-Louis, URP-3518, Assistance Publique-Hôpitaux de Paris, University Hospital Saint-Louis, 75010, Paris, France

    Nicolas Boissel

  6. Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France

    Nicolas Boissel & Marie Robin

  7. Service d’Hématologie, CHU de Poitiers, Poitiers, France

    Natacha Maillard

  8. Institute of Pediatric Hematology and Oncology (IHOPe), Lyon, France

    Marie Ouachée-Chardin

  9. Service d’Hématologie Clinique et Thérapie Cellulaire, CHU Bordeaux, F-33000, Bordeaux, France

    Edouard Forcade

  10. Section of Hematology, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium

    Xavier Poiré

  11. Institut d’Hématologie de Basse Normandie, CHU Caen, Caen, France

    Sylvain Chantepie

  12. CHU – IUCT O, 31059, Toulouse, Toulouse, France

    Anne Huynh

  13. CHU Grenoble Alpes, Grenoble, France

    Claude Eric Bulabois

  14. Service d’Hématologie et de Thérapie Cellulaire, Hôpital Henri Mondor, Créteil, France

    Mathieu Leclerc & Sébastien Maury

  15. University of Nantes, CHU Hôtel Dieu, Nantes, France

    Patrice Chevallier

  16. Université Nice Côte d’azur, CHU de Nice, Nice, France

    Thomas Cluzeau

  17. CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000, Rennes, France

    Jean-Baptiste Mear

  18. Département d’Hématologie Clinique et de Thérapie Cellulaire, CHU de Saint Etienne, Saint-Priest-en-Jarez, France

    Jérôme Cornillon

  19. Service d’Hématologie, Institut de cancérologie Strasbourg Europe (ICANS), Strasbourg, France

    Karin Bilger & Célestine Simand

  20. Division of Haematology, Department of Medicine, University and CHU of Liège, Liège, Belgium

    Yves Beguin

  21. Service d’Hématologie, Hôpital Brabois, CHRU Nancy, Equipe 6 IMoPa, Biopole de L’université de Lorraine, CNRS UMR 7563, Nancy, France

    Marie-Thérèse Rubio

  22. CHU de Lille, université de Lille, Inserm U1286, Infinite, 59000, Lille, France

    Ibrahim Yakoub-Agha

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  1. Paul Chauvet
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Contributions

PCha, EB, AP, MLa and IYA designed the study. AP and MLa performed statistical analysis. PCha, EB, AP, MLa and IYA analyzed data. PCha and EB wrote the manuscript. All authors collected data and reviewed the manuscript.

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Correspondence to Paul Chauvet or Eolia Brissot.

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PChe has received honoraria from Amgen. The other authors declare no conflict of interest relative to this work.

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Chauvet, P., Paviglianiti, A., Labopin, M. et al. Combining blinatumomab and donor lymphocyte infusion in B-ALL patients relapsing after allogeneic hematopoietic cell transplantation: a study of the SFGM-TC. Bone Marrow Transplant 58, 72–79 (2023). https://doi.org/10.1038/s41409-022-01846-9

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