Immunotherapy is an alternative treatment modality for poor conditions associated with chemoresistance like refractory/relapsing primary B-precursor acute lymphoblastic leukaemia or minimal residual disease persistence. The immunotherapeutic effect of allogeneic stem cell transplantation is largely exploited in this context but graft-versus-host disease remains a major concern. Recently, improvements have been made in selectively engaging the immune system against the persistent disease. Blinatumomab is a dual binding antibody construct that redirects any T lymphocytes against B-precursor acute lymphoblastic leukaemia blasts. It shows a very good activity in monotherapy in those poor risk conditions and is associated with a low toxicity profile suggesting this use earlier and in combination in the therapeutic course of B-precursor acute lymphoblastic leukaemia patients. In this article, after a short overview of immunotherapeutic advances in B-precursor acute lymphoblastic leukaemia, the results of the main trials conducted with blinatumomab are discussed and put in perspective.
(BELG J HEMATOL 2017;8(3):107–12)