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The BLIND study: blinatumomab and DLI approach for management of B-ALL relapse after allogeneic stem cell transplantation. A multicentric Italian experience

Bone Marrow Transplantation volume 60, pages 396–399 (2025)Cite this article

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Allogeneic hematopoietic stem cell transplantation (alloHSCT) offers a potentially curative option for acute lymphoblastic leukemia (ALL). The 5-year overall survival is only 30–40% in adults and elderly patients with ALL compared to 90% in children. The major advances in the understanding and management of ALL related to the identification of new cytogenetic and molecular abnormalities and development of novel targeted agents for the treatment of ALL, considerably improved response rates, with the use of risk-adapted treatment strategies. The management of relapsed disease after HSCT involves the usage of chemo-, immuno- and cellular therapy with no standardized management [1].

Blinatumomab is a bispecific T-cell engager antibody used in the treatment of ALL since 2014. The TOWER study has shown the superiority of blinatumomab to conventional chemotherapy in R/R Ph- B-ALL patients: median OS (7.7 vs. 4.0 months) and CR rate (34% vs. 16%), with higher remission rates also in patients who had undergone alloHSCT before receiving blinatumomab [2]. The use of Blinatumomab in maintenance after HSCT is under study in patients with high risk of relapse or in MRD+ patients after HSCT [3, 4].

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Dipartimento di Scienze di Laboratorio ed Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    S. Giammarco, P. Chiusolo, L. Teofili, N. Piccirilo, E. Metafuni, M. A. Limongiello & S. Sica

  2. Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy

    R. Maggi, Luca Di Marino, P. Chiusolo, L. Teofili, N. Piccirilo & S. Sica

  3. Divisione Clinicizzata di Ematologia con Trapianto di Midollo Osseo. Azienda ospedaliero-universitaria “Policlinico G. Rodolico - San Marco” Catania, Catania, Italy

    S. Leotta, G. Milone & A. Cupri

  4. SOD terapie cellulari e medicina trasfusionale, Azienda Ospedaliera- Universitaria, Careggi, Firenze, Italy

    I. Cutini, R. Saccardi, C. Nozzoli, R. Boncompagni & A. Gozzini

  5. Hematology Department, Azienda Ospedaliera- Universitaria, Careggi, Firenze, Italy

    B. Scappini & M. Piccini

  6. Fondazione IRCCS Ca’ Granda Ospedale Maggiore, Policlinico Milano, Italy

    N. S. Fracchiolla

Authors
  1. S. Giammarco
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  2. R. Maggi
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  3. Luca Di Marino
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  4. P. Chiusolo
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  5. L. Teofili
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  6. N. Piccirilo
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  7. E. Metafuni
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  8. M. A. Limongiello
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  9. S. Leotta
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  10. G. Milone
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  12. I. Cutini
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  14. C. Nozzoli
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  15. R. Boncompagni
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  16. A. Gozzini
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  18. M. Piccini
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  19. N. S. Fracchiolla
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  20. S. Sica
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Contributions

SG, SS and PC designed the study; SG, RM and LDM merged, revised and analyzed the data from all participating centers; LT and NP, as responsible of the cell manipulation laboratory, were involved in the harvest of the lymphocytes; EM and MAL were involved in the management of patients at Fondazione Policlinico Universitario A. Gemelli IRCCS; SL, GM and AC were involved in the management of patients at Azienda ospedaliero-universitaria “Policlinico G. Rodolico - San Marco” Catania; IC, RS, CN, RB, AG, BS, MP were involved in the management of patients at Azienda Ospedaliera- Universitaria, Careggi, Firenze; NSF was involved in the management of patients at Fondazione IRCCS Ca’ Granda Ospedale Maggiore, Policlinico Milano, SG, RM and LDM wrote the paper, SS and RS revised the manuscript.

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Correspondence to S. Sica.

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Giammarco, S., Maggi, R., Di Marino, L. et al. The BLIND study: blinatumomab and DLI approach for management of B-ALL relapse after allogeneic stem cell transplantation. A multicentric Italian experience. Bone Marrow Transplant 60, 396–399 (2025). https://doi.org/10.1038/s41409-024-02475-0

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