Blinatumomab in relapsed/refractory diffuse large B cell lymphoma

Excerpt

Although the introduction of the monoclonal antibody rituximab as part of the treatment regimen for B cell non-Hodgkin lymphoma has improved outcomes considerably [1], 30 to 50% of patients with diffuse large B cell lymphoma (DLBCL) are not cured with conventional chemo-immunotherapy [2]. Especially, those who relapse within 12 months after receiving rituximab-containing first line chemotherapy have a poor prognosis [3]. Standard clinical practice in first relapse for patients eligible for transplant is platinum-based salvage chemotherapy, followed by high-dose chemotherapy (HDCT) with autologous stem cell transplantation (ASCT) as remission consolidation. Allogenic stem cell transplantation is considered in patients who relapse after HDCT with ASCT or in patients with poor-risk factors at relapse [2]. However, following early relapse (within 12 months after diagnosis), fewer than 10% of patients experience prolonged disease-free survival with second-line treatment regimens [4]. Thus, there is a high unmet medical need in this heavily pretreated population with inherent poor prognosis. Blinatumomab is a CD19-CD3-bispecific T cell engager (BiTE) antibody construct approved for the treatment of adults with Philadelphia chromosome-negative relapsed or refractory B-precursor acute lymphoblastic leukemia (ALL). Our case illustrates the use of blinatumomab monotherapy as a bridge to allogenic stem cell transplantation in relapsed/refractory DLBCL after ASCT. …