The integration of blinatumomab consolidation in the CALGB 10403 regimen for adults with B-cell precursor acute lymphoblastic leukaemia in measurable residual disease-negative remission.

Blinatumomab consolidation was recently approved for patients with acute lymphoblastic leukaemia (ALL) who achieve measurable residual disease (MRD) negative remission based on the survival benefit yielded in the E1910 trial. The CALGB 10403 (C10403) is the most frequently used paediatric inspired regimen for young adults treated in the United States; however, data and guidance on how to best incorporate blinatumomab consolidation into the C10403 regimen are lacking. Here, we describe our experience of adding blinatumomab consolidation to the C10403 regimen per our institutional consensus. Thirty-one adult patients met inclusion criteria. The median age was 31 years and the majority were males (64.5%) and Hispanic (83.9%). The most common ALL subtype was Philadelphia-like (45.2%). The median follow-up was 13.7 months and the median overall survival was not reached (NR) (95% confidence interval [CI] NR-NR) with one death occurring post allogenic transplant and one relapse (3.2%). All-grade cytokine release syndrome and treatment-related neurological/psychiatric adverse event rates were 9.7% and 19.4%, respectively, and none of the patients permanently discontinued blinatumomab due to toxicity. The majority (84.6%) of patients were able to receive over half of their planned pegaspargase doses. The incorporation of blinatumomab consolidation to C10403 is safe and feasible in adults with ALL.