Switching from salvage chemotherapy to immunotherapy in adult B-cell acute lymphoblastic leukemia

David Kegyes, Ciprian Jitaru, Gabriel Ghiaur, Stefan Ciurea, Dieter Hoelzer, Ciprian Tomuleasa, Robert Peter Gale

Research output: Contribution to journalReview articlepeer-review

Abstract

About one-half of adults with acute B-cell lymphoblastic leukemia (B-ALL) who do not achieve molecular complete remission or who subsequently relapse are not cured by current chemo- or targeted therapies. Previously, the sole therapeutic option for such persons was a hematopoietic stem cell transplant. Recently, several immune therapies including monoclonal antibodies, bispecific T-cell engagers (BiTEs), antibody-drug conjugates (ADCs), and chimeric antigen receptor T-cells (CARs) have been shown safe and effective in this setting. In this manuscript, we summarize data on US FDA-approved immune therapies of advanced adult B-ALL including rituximab, blinatumomab, inotuzumab ozogamicin, tisagenlecleucel and brexucabtagene autoleucel. We consider the results of clinical trials focusing on efficacy, safety, and quality of life (QoL). Real-world evidence is presented as well. We also briefly discuss pharmacodynamics, pharmacokinetics, and pharmacoeconomics followed by risk-benefit analyses. Lastly, we present future directions of immune therapies for advanced B-ALL in adults.

Original languageEnglish (US)
Article number101042
JournalBlood Reviews
Volume59
DOIs
StatePublished - May 2023

Keywords

  • B-cell acute lymphoblastic leukemia
  • Blinatumomab
  • Brexucabtagene autoleucel
  • Immune therapy
  • Inotuzumab ozogamicin
  • Tisagenlecleucel

ASJC Scopus subject areas

  • Hematology
  • Oncology

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