Frontiers in Immunology (Dec 2019)

Let’s Talk About BiTEs and Other Drugs in the Real-Life Setting for B-Cell Acute Lymphoblastic Leukemia

  • Dalma Deak,
  • Dalma Deak,
  • Cristina Pop,
  • Alina-Andreea Zimta,
  • Ancuta Jurj,
  • Alexandra Ghiaur,
  • Sergiu Pasca,
  • Patric Teodorescu,
  • Angela Dascalescu,
  • Angela Dascalescu,
  • Ion Antohe,
  • Ion Antohe,
  • Bogdan Ionescu,
  • Catalin Constantinescu,
  • Anca Onaciu,
  • Raluca Munteanu,
  • Ioana Berindan-Neagoe,
  • Bobe Petrushev,
  • Cristina Turcas,
  • Cristina Turcas,
  • Sabina Iluta,
  • Cristina Selicean,
  • Mihnea Zdrenghea,
  • Mihnea Zdrenghea,
  • Alina Tanase,
  • Catalin Danaila,
  • Catalin Danaila,
  • Anca Colita,
  • Anca Colita,
  • Andrei Colita,
  • Andrei Colita,
  • Delia Dima,
  • Daniel Coriu,
  • Daniel Coriu,
  • Daniel Coriu,
  • Hermann Einsele,
  • Ciprian Tomuleasa

DOI
https://doi.org/10.3389/fimmu.2019.02856
Journal volume & issue
Vol. 10

Abstract

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Background: Therapy for acute lymphoblastic leukemia (ALL) are currently initially efficient, but even if a high percentage of patients have an initial complete remission (CR), most of them relapse. Recent data shows that immunotherapy with either bispecific T-cell engagers (BiTEs) of chimeric antigen receptor (CAR) T cells can eliminate residual chemotherapy-resistant B-ALL cells.Objective: The objective of the manuscript is to present improvements in the clinical outcome for chemotherapy-resistant ALL in the real-life setting, by describing Romania's experience with bispecific antibodies for B-cell ALL.Methods: We present the role of novel therapies for relapsed B-cell ALL, including the drugs under investigation in phase I-III clinical trials, as a potential bridge to transplant. Blinatumomab is presented in a critical review, presenting both the advantages of this drug, as well as its limitations.Results: Bispecific antibodies are discussed, describing the clinical trials that resulted in its approval by the FDA and EMA. The real-life setting for relapsed B-cell ALL is described and we present the patients treated with blinatumomab in Romania.Conclusion: In the current manuscript, we present blinatumomab as a therapeutic alternative in the bridge-to-transplant setting for refractory or relapsed ALL, to gain a better understanding of the available therapies and evidence-based data for these patients in 2019.

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