Abstract：
Blinatumomab and inotuzumab ozogamicin (INO) are both active in relapsed/refractory B-cell acute lymphoblastic leukemia (ALL) and improve outcomes compared with conventional chemotherapy in this setting. Several prospective clinical trials have explored the use of these agents in adults with newly diagnosed B-cell ALL, with promising outcomes observed in younger and older adults and in both Philadelphia chromosome (Ph)-positive and Ph-negative ALL. These novel regimens result in high rates of deep measurable residual disease (MRD) negativity and may improve survival compared with chemotherapy-only approaches, allowing for less reliance on intensive chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT). This review discusses novel approaches to integrating INO and/or blinatumomab into frontline ALL regimens, including the potential role of chemotherapy-free regimens in some subgroups. The role of MRD monitoring is also discussed, including how this can inform decisions for consolidative allogeneic HSCT or investigational approaches with CD19 CAR T-cells.
摘要：
在这种情况下，与常规化疗相比，linatumomab和伊托单抗ozogamicin（INO）在复发性/难治性B细胞急性淋巴细胞白血病（ALL）中均具有活性，并改善了预后。一些前瞻性临床试验已经探索了这些药物在新诊断的成人B细胞ALL中的应用。在年轻人和老年人以及费城染色体（Ph）阳性和Ph阴性ALL中观察到有希望的结果。与单纯化疗相比，这些新方案可导致较高的深度可测量残留病（MRD）阴性率，并可提高生存率。减少对强化化疗和异基因造血干细胞移植（HSCT）的依赖。这篇综述讨论了将INO和/或blinatumomab整合到一线ALL方案中的新方法，包括无化疗方案在某些亚组中的潜在作用.还讨论了MRD监测的作用，包括这如何为整合同种异体HSCT或使用CD19CART细胞的研究性方法的决策提供信息。
