Outcomes for Australian children with relapsed/refractory acute lymphoblastic leukaemia treated with blinatumomab

We report on the Australian experience of blinatumomab for treatment of 24 children with relapsed/refractory precursor B‐cell acute lymphoblastic leukaemia (B‐ALL) and high‐risk genetics, resulting in a minimal residual disease (MRD) response rate of 58%, 2‐year progression‐free survival (PFS) of 39% and 2‐year overall survival of 63%. In total, 83% (n = 20/24) proceeded to haematopoietic stem cell transplant, directly after blinatumomab (n = 12) or following additional salvage therapy (n = 8). Four patients successfully received CD19‐directed chimeric antigen receptor T‐cell therapy despite prior blinatumomab exposure. Inferior 2‐year PFS was associated with MRD positivity (20%, n = 15) and in KMT2A‐rearranged infants (15%, n = 9). Our findings highlight that not all children with relapsed/refractory B‐ALL respond to blinatumomab and factors such as blast genotype may affect prognosis.Rosemary Sutton, Luciano Dalla Pozza, Seong Lin Khaw, Chris Fraser, Tom Revesz, Janis Chamberlain, Richard Mitchell, Toby N. Trahair, Caroline M. Bateman, Nicola C. Venn, Tamara Law, Erika Ong, Susan L. Heatley, Barbara J. McClure, Claus Meyer, Rolf Marschalek, Michelle J. Henderson, Siobhan Cross, Deborah L. White, Rishi S. Kotech