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      Total body irradiation-based haploidentical hematopoietic stem cell transplantation using posttransplant cyclophosphamide after administration of inotuzumab ozogamicin: A case report

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          Abstract

          Owing to the poor prognosis of relapsed or refractory acute lymphoblastic leukemia (ALL), hematopoietic stem cell transplantation (HSCT) followed by effective salvage therapy is required. Inotuzumab ozogamicin (INO) was developed for ALL refractory to standard chemotherapy. However, previous reports suggest that sinusoidal obstruction syndrome (SOS) risk increases in patients with HSCT receiving INO, especially with dual alkylating agents. We report a case of relapsed Philadelphia chromosome-negative B-ALL where the patient underwent haploidentical HSCT using fludarabine/total body irradiation conditioning and posttransplant cyclophosphamide. Successful engraftment was achieved without SOS development.

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          Tisagenlecleucel in Children and Young Adults with B-Cell Lymphoblastic Leukemia

          Shannon Maude, Theodore Laetsch, Jochen Buechner … (2018)
          In a single-center phase 1-2a study, the anti-CD19 chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel produced high rates of complete remission and was associated with serious but mainly reversible toxic effects in children and young adults with relapsed or refractory B-cell acute lymphoblastic leukemia (ALL).
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            Blinatumomab versus Chemotherapy for Advanced Acute Lymphoblastic Leukemia

            Hagop Kantarjian, Anthony Stein, Nicola Gökbuget … (2017)
            Background Blinatumomab, a bispecific monoclonal antibody construct that enables CD3-positive T cells to recognize and eliminate CD19-positive acute lymphoblastic leukemia (ALL) blasts, was approved for use in patients with relapsed or refractory B-cell precursor ALL on the basis of single-group trials that showed efficacy and manageable toxic effects. Methods In this multi-institutional phase 3 trial, we randomly assigned adults with heavily pretreated B-cell precursor ALL, in a 2:1 ratio, to receive either blinatumomab or standard-of-care chemotherapy. The primary end point was overall survival. Results Of the 405 patients who were randomly assigned to receive blinatumomab (271 patients) or chemotherapy (134 patients), 376 patients received at least one dose. Overall survival was significantly longer in the blinatumomab group than in the chemotherapy group. The median overall survival was 7.7 months in the blinatumomab group and 4.0 months in the chemotherapy group (hazard ratio for death with blinatumomab vs. chemotherapy, 0.71; 95% confidence interval [CI], 0.55 to 0.93; P=0.01). Remission rates within 12 weeks after treatment initiation were significantly higher in the blinatumomab group than in the chemotherapy group, both with respect to complete remission with full hematologic recovery (34% vs. 16%, P<0.001) and with respect to complete remission with full, partial, or incomplete hematologic recovery (44% vs. 25%, P<0.001). Treatment with blinatumomab resulted in a higher rate of event-free survival than that with chemotherapy (6-month estimates, 31% vs. 12%; hazard ratio for an event of relapse after achieving a complete remission with full, partial, or incomplete hematologic recovery, or death, 0.55; 95% CI, 0.43 to 0.71; P<0.001), as well as a longer median duration of remission (7.3 vs. 4.6 months). A total of 24% of the patients in each treatment group underwent allogeneic stem-cell transplantation. Adverse events of grade 3 or higher were reported in 87% of the patients in the blinatumomab group and in 92% of the patients in the chemotherapy group. Conclusions Treatment with blinatumomab resulted in significantly longer overall survival than chemotherapy among adult patients with relapsed or refractory B-cell precursor ALL. (Funded by Amgen; TOWER ClinicalTrials.gov number, NCT02013167 .).
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              Inotuzumab Ozogamicin versus Standard Therapy for Acute Lymphoblastic Leukemia

              Hagop Kantarjian, Daniel J. DeAngelo, Matthias Stelljes … (2016)
              The prognosis for adults with relapsed acute lymphoblastic leukemia is poor. We sought to determine whether inotuzumab ozogamicin, an anti-CD22 antibody conjugated to calicheamicin, results in better outcomes in patients with relapsed or refractory acute lymphoblastic leukemia than does standard therapy.
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                Author and article information

                Contributors
                Nobuharu Fujii
                Journal
                Journal ID (nlm-ta): Leuk Res Rep
                Journal ID (iso-abbrev): Leuk Res Rep
                Title: Leukemia Research Reports
                Publisher: Elsevier
                ISSN (Electronic): 2213-0489
                Publication date PMC-release: 22 April 2021
                Publication date Collection: 2021
                Publication date (Electronic): 22 April 2021
                Volume: 15
                Electronic Location Identifier: 100241
                Affiliations
                [a ]Department of Hematology and Oncology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama Prefecture 700-8558, Japan
                [b ]Department of Transfusion Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama Prefecture 700-8558, Japan
                Author notes
                [* ]Corresponding author: Nobuharu Fujii, Department of Hematology and Oncology, Okayama University Hospital Address: 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama Prefecture 700-8558, Japan. nfujii@ 123456md.okayama-u.ac.jp
                Article
                Publisher Item ID: S2213-0489(21)00008-X Publisher ID: 100241
                DOI: 10.1016/j.lrr.2021.100241
                PMC ID: 8111671
                SO-VID: 00fc5e62-5c39-426b-84e8-1b36a1bbd275
                Copyright © © 2021 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 25 March 2021
                Date accepted : 18 April 2021
                Categories
                Subject: Article

                Keywords: acute lymphoblastic leukemia,inotuzumab ozogamicin,sinusoidal obstruction syndrome,hematopoietic stem cell transplantation,posttransplant cyclophosphamide
                Data availability:
                Keywords: acute lymphoblastic leukemia, inotuzumab ozogamicin, sinusoidal obstruction syndrome, hematopoietic stem cell transplantation, posttransplant cyclophosphamide

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