PMID- 36703737
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230202
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 13
DP  - 2022
TI  - Efficacy and safety of blinatumomab in children with relapsed/refractory B cell 
      acute lymphoblastic leukemia: A systematic review and meta-analysis.
PG  - 1032664
LID - 10.3389/fphar.2022.1032664 [doi]
LID - 1032664
AB  - Objectives: Several clinical trials have been conducted to evaluate the effects 
      of blinatumomab in childhood B cell acute lymphoblastic leukemia (B-ALL). We 
      conducted this meta-analysis to validate the efficacy and safety of blinatumomab 
      in pediatric patients with relapsed/refractory B-ALL (R/R B-ALL). Methods: We 
      searched and investigated all relevant studies in the PubMed, Web of Science, 
      Embase, and Cochrane Library databases. The primary outcomes were complete 
      response (CR), overall survival (OS), event free survival (EFS), minimal residual 
      disease (MRD) response, allogeneic hematopoietic stem cell transplantation 
      (allo-HSCT) and were calculated separately for randomized controlled trials 
      (RCTs) and single-arm studies. The secondary end points were adverse effects 
      (AEs) and the relapse rate. The Cochrane, bias assessment tool, was used to 
      assess the risk of bias in RCTs. The methodological quality of single-arm studies 
      was assessed using the methodological index for non-randomized studies (MINORS) 
      tool. Results: The meta-analysis included two RCTs and 10 single-arm studies, 
      including 652 patients in total. Our study showed that in the single-arm studies, 
      the combined CR rate was 0.56 (95% confidence interval (CI): 0.45 -0.68), the 
      odds ratios (ORs) of OS was 0.43 (95% CI 0.32 -0.54), the EFS rate was 0.30 (95% 
      CI: 0.20 -0.40), the MRD response was 0.51 (95% CI: 0.34 -0.68), allo-HSCT rate 
      was 0.62 (95% CI: 0.50 -.74), the AE rate was 0.65 (95% CI: 0.54 -0.76) and the 
      relapse rate was 0.32 (95% CI: 0.27 -0.38). In the RCTs, the blinatumomab-treated 
      group compared with the chemotherapy group had a combined OS rate of 0.12 (95% 
      CI: 0.05 -0.19) and an EFS rate of 2.16 (95% CI: 1.54 -3.03). The pooled MRD 
      response rate was 4.71 (95% CI:2.84 -7.81), allo-HSCT was 3.24 (95% CI: 1.96 
      -5.35), the AE rate was 0.31 (95% CI: 0.16 -0.60), and the relapse rate was 0 .69 
      (95% CI: 0.43 -1.09). Conclusion: According to this meta-analysis, blinatumomab 
      shows potent therapeutic efficacy and limited AEs in children with R/R B- ALL. 
      Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier 
      CRD42022361914.
CI  - Copyright (c) 2023 Chen, Zou, Zhang, Chen, Zhang, Xiao and Li.
FAU - Chen, Bin
AU  - Chen B
AD  - Department of Pediatrics, West China Second University Hospital, Sichuan 
      University, Chengdu, China.
AD  - Key Laboratory of Birth Defects and Related Diseases of Women and Children, 
      Sichuan University, Chengdu, China.
FAU - Zou, Zhuan
AU  - Zou Z
AD  - Department of Pediatrics, West China Second University Hospital, Sichuan 
      University, Chengdu, China.
AD  - Key Laboratory of Birth Defects and Related Diseases of Women and Children, 
      Sichuan University, Chengdu, China.
FAU - Zhang, Qian
AU  - Zhang Q
AD  - Department of Pediatrics, West China Second University Hospital, Sichuan 
      University, Chengdu, China.
AD  - Key Laboratory of Birth Defects and Related Diseases of Women and Children, 
      Sichuan University, Chengdu, China.
FAU - Chen, Kexing
AU  - Chen K
AD  - Department of Pediatrics, West China Second University Hospital, Sichuan 
      University, Chengdu, China.
AD  - Key Laboratory of Birth Defects and Related Diseases of Women and Children, 
      Sichuan University, Chengdu, China.
FAU - Zhang, Xiaoyan
AU  - Zhang X
AD  - Department of Pediatrics, West China Second University Hospital, Sichuan 
      University, Chengdu, China.
AD  - Key Laboratory of Birth Defects and Related Diseases of Women and Children, 
      Sichuan University, Chengdu, China.
FAU - Xiao, Dongqiong
AU  - Xiao D
AD  - Department of Pediatrics, West China Second University Hospital, Sichuan 
      University, Chengdu, China.
AD  - Key Laboratory of Birth Defects and Related Diseases of Women and Children, 
      Sichuan University, Chengdu, China.
FAU - Li, Xihong
AU  - Li X
AD  - Department of Pediatrics, West China Second University Hospital, Sichuan 
      University, Chengdu, China.
AD  - Key Laboratory of Birth Defects and Related Diseases of Women and Children, 
      Sichuan University, Chengdu, China.
LA  - eng
PT  - Systematic Review
DEP - 20230110
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC9871389
OTO - NOTNLM
OT  - blinatumomab
OT  - child
OT  - meta-analysis
OT  - relapsed/refractory acute lymphoblastic leukemia (R/R ALL)
OT  - systemic review
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/01/28 06:00
MHDA- 2023/01/28 06:01
PMCR- 2023/01/10
CRDT- 2023/01/27 02:15
PHST- 2022/08/31 00:00 [received]
PHST- 2022/12/20 00:00 [accepted]
PHST- 2023/01/27 02:15 [entrez]
PHST- 2023/01/28 06:00 [pubmed]
PHST- 2023/01/28 06:01 [medline]
PHST- 2023/01/10 00:00 [pmc-release]
AID - 1032664 [pii]
AID - 10.3389/fphar.2022.1032664 [doi]
PST - epublish
SO  - Front Pharmacol. 2023 Jan 10;13:1032664. doi: 10.3389/fphar.2022.1032664. 
      eCollection 2022.