PMID- 36593170
OWN - NLM
STAT- MEDLINE
DCOM- 20230302
LR  - 20230320
IS  - 2152-2669 (Electronic)
IS  - 2152-2669 (Linking)
VI  - 23
IP  - 3
DP  - 2023 Mar
TI  - Efficacy and Safety of Blinatumomab for the Treatment of Relapsed/Refractory 
      Acute Lymphoblastic Leukemia: A Systemic Review and Meta-Analysis.
PG  - e139-e149
LID - S2152-2650(22)01772-4 [pii]
LID - 10.1016/j.clml.2022.12.009 [doi]
AB  - OBJECTIVE: The aim was to evaluate the efficacy and safety of blinatumomab 
      monotherapy for the treatment of relapsed/refractory acute lymphoblastic leukemia 
      (R/R B-ALL). METHODS: PubMed, Embase, Web of Science, and Cochrane Library were 
      searched to collect clinical studies related to blinatumomab. The primary outcome 
      measures were complete remission (CR), and minimal residual disease (MRD) 
      response. Prognostic indicators included overall survival (OS) and relapse-free 
      survival time (RFS). Grade >/=3 adverse reactions were mainly analyzed for safety, 
      including cytokine release syndrome (CRS), neurological events and hematological 
      toxicity. The heterogeneity was quantified by I(2) statistic, which reflected the 
      proportion of the true heterogeneity to the variance of the total effect size. 
      Studies were considered heterogeneous if the I(2) statistic was greater than 50%, 
      and conversely, studies were homogeneous. RESULTS: A total of 18 studies 
      involving 1,373 patients were included. The analysis results showed a CR rate of 
      54% (95%CI:44%-64%) and an MRD response rate of 43% (95%CI:34%-51%). The CR rate 
      was higher in patients with bone marrow (BM) blast <50% than in patients with BM 
      blast >/=50% (71% vs. 34%). The median OS and RFS were 8.16 months 
      (95%CI:6.64-9.69) and 6.02 months (95%CI:4.63-7.41), respectively. For safety 
      analysis, the incidence of grade >/=3 adverse events (AEs) was 80% (95%CI:72%-88%), 
      the incidence of grade >/=3 neurological toxicity was 7% (95%CI:4%-11%), and the 
      incidence of grade >/=3 CRS was 3% (95%CI:2%-5%). However, the mixture of 
      retrospective and prospective studies led to heterogeneity to some extent in this 
      meta-analysis. CONCLUSION: Blinatumomab is effective in the treatment of R/R 
      B-ALL with a controlled occurrence of AEs and a reliable safety profile.
CI  - Copyright (c) 2022 Elsevier Inc. All rights reserved.
FAU - Liu, Heng
AU  - Liu H
AD  - Department of Hematology, the 940th Hospital of Joint Logistic Support Force of 
      the Chinese People's Liberation Army, Lanzhou 730050, China.
FAU - Xi, Rui
AU  - Xi R
AD  - Department of Hematology, the 940th Hospital of Joint Logistic Support Force of 
      the Chinese People's Liberation Army, Lanzhou 730050, China.
FAU - Mao, Dongfeng
AU  - Mao D
AD  - Department of Hematology, the 940th Hospital of Joint Logistic Support Force of 
      the Chinese People's Liberation Army, Lanzhou 730050, China.
FAU - Zhao, Xiaochen
AU  - Zhao X
AD  - Department of Hematology, the 940th Hospital of Joint Logistic Support Force of 
      the Chinese People's Liberation Army, Lanzhou 730050, China.
FAU - Wu, Tao
AU  - Wu T
AD  - Department of Hematology, the 940th Hospital of Joint Logistic Support Force of 
      the Chinese People's Liberation Army, Lanzhou 730050, China. Electronic address: 
      wutaozhen@yeah.net.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20221217
PL  - United States
TA  - Clin Lymphoma Myeloma Leuk
JT  - Clinical lymphoma, myeloma & leukemia
JID - 101525386
RN  - 0 (Antibodies, Bispecific)
RN  - 4FR53SIF3A (blinatumomab)
SB  - IM
MH  - Humans
MH  - *Antibodies, Bispecific
MH  - *Leukemia, Lymphoid/drug therapy
MH  - *Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/therapy
MH  - Prospective Studies
MH  - Recurrence
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Adverse event
OT  - Bispecific antibody
OT  - CD19
OT  - Complete remission
OT  - Outcome
COIS- Disclosure The authors have no relevant financial or non-financial interests to 
      disclose. The authors declare that no funds, grants, or other support were 
      received during the preparation of this manuscript.
EDAT- 2023/01/03 06:00
MHDA- 2023/03/03 06:00
CRDT- 2023/01/02 21:53
PHST- 2022/10/13 00:00 [received]
PHST- 2022/12/08 00:00 [revised]
PHST- 2022/12/14 00:00 [accepted]
PHST- 2023/01/03 06:00 [pubmed]
PHST- 2023/03/03 06:00 [medline]
PHST- 2023/01/02 21:53 [entrez]
AID - S2152-2650(22)01772-4 [pii]
AID - 10.1016/j.clml.2022.12.009 [doi]
PST - ppublish
SO  - Clin Lymphoma Myeloma Leuk. 2023 Mar;23(3):e139-e149. doi: 
      10.1016/j.clml.2022.12.009. Epub 2022 Dec 17.