Dat Ngo, Jose Tinajero, Joo Y Song, Huiyan Ma, Elizabeth Quirk, Paul Koller, Hoda Pourhassan, Vaibhav Agrawal, Anthony S Stein, Guido Marcucci, Lindsey Murphy, Stephen J Forman, Vinod Pullarkat, Ibrahim Aldoss
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引用次数: 0
摘要
使用blinatumomab后观察到脑脊液中出现反应性多细胞，但尚未对此进行详细描述。我们对88例在使用blinatumomab期间接受鞘内化疗（IT）的患者进行了回顾性研究，并对CSF进行了分析，以确定多核细胞是否会影响疗效和安全性。62.5%的复发/难治患者、31.8%的MRD阳性患者和5.7%的MRD阴性患者接受了Blinatumomab的巩固治疗。CSF中多细胞的发生率为51%，第15天后更常见（55.8% vs. 18.2%，p = 0.025）。胸水细胞增多并不影响CR、MRD阳性清除率、PFS和OS率。CSF中出现多核细胞的非中枢神经系统髓外复发率较低（3.7% vs. 30.8%，p = 0.011）。流式细胞术对 CSF 的分析表明，CD4:CD8 比率的中位数为 1.34。总之，脑脊液多核细胞增多在使用 blinatumomab 时很常见，但只显示出非中枢神经系统髓外复发率较低，而对中枢神经系统复发或神经毒性没有影响。
The characterization and the impact of CSF pleocytosis during blinatumomab therapy for adult acute lymphoblastic leukemia.
Reactive pleocytosis in the CSF has been observed with blinatumomab but has not been well-described. We performed a retrospective study of 88 patients who received intrathecal chemotherapy (IT) while on blinatumomab with CSF analyzed to determine if pleocytosis had an impact efficacy and safety. Blinatumomab was used for relapsed/refractory 62.5%, MRD-positive 31.8%, and consolidation in MRD-negative 5.7%. The incidence of pleocytosis in CSF was 51% and was more frequent after day 15 (55.8% vs. 18.2%, p = 0.025). Pleocytosis did not impact CR, clearance of MRD positivity, PFS and OS rates. Lower incidence of non-CNS extramedullary relapse was seen (3.7% vs. 30.8%, p = 0.011) with pleocytosis in CSF. Analysis of CSF by flow cytometry showed median CD4:CD8 ratio of 1.34. In conclusion, CSF pleocytosis is prevalent with blinatumomab but only demonstrated lower rates of non-CNS extramedullary relapse but no impact on CNS relapse or neurotoxicity.
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Leukemia & Lymphoma in its fourth decade continues to provide an international forum for publication of high quality clinical, translational, and basic science research, and original observations relating to all aspects of hematological malignancies. The scope ranges from clinical and clinico-pathological investigations to fundamental research in disease biology, mechanisms of action of novel agents, development of combination chemotherapy, pharmacology and pharmacogenomics as well as ethics and epidemiology. Submissions of unique clinical observations or confirmatory studies are considered and published as Letters to the Editor
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