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Acute lymphoblastic leukemia treated with bispecific antibody Blinatumomab: low MRD after therapy linked to higher chance to maintain complete remission


In acute lymphoblastic leukemia ( ALL ) response to therapy is usually measured by microscopic analysis of the bone marrow. The detection level for leukemic cells by this method is 5%. With molecular biologic tests the sensitivity is increased and 0.01% leukemia cells can be detected. This low level of leukemia cells is called minimal residual disease ( MRD ).

In a clinical trial with the bispecific antibody Blinatumomab ( BITE ) 189 patients with relapsed / refractory ( r/r ) acute lymphoblastic leukemia were treated.
43% achieved a complete remission ( CR ), which means that no leukemia cells were detectable with microscopy.

One explorative goal of the trial was the measurement of MRD in patients with complete remission. MRD evaluation was conducted in a central laboratory.
With MRD detection it could be demonstrated that 82% of the patients with complete remission showed a low level of MRD ( less than 0.01% ) and 70% had no detectable MRD.

Patients with low MRD after first therapy usually have a higher chance to maintain complete remission.

It will be analysed whether this is also relevant in r/r acute lymphoblastic leukemia and whether MRD detection allows to discriminate good risk patients better than conventional remission evaluation. ( Xagena )

Source: European Hematology Association Congress, 2014

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