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December 8, 2025BloodOpen Access

Low-intensity cytoreduction with low-dose cytarabine prior to blinatumomab for pediatric and AYA R/R ALL integrated with multi-omics analysis to discover predictive biomarkers: Initial results from JPLSG-ALL-R19-blin

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Authors

IKItaru KatoHKHirokazu KobushiASAkiko Saito

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Overview

Phase I/II study shows low-dose cytarabine plus blinatumomab improves treatment response in pediatric acute lymphoblastic leukemia, indicating potential predictive biomarkers.

Key Points

  • This research aims to evaluate low-dose cytarabine cytoreduction followed by blinatumomab in pediatric and AYA patients with relapsed acute lymphoblastic leukemia.
  • Conducted a phase I/II trial including pediatric and AYA patients with relapsed B-ALL.
  • Patients received continuous infusion of cytarabine followed by cycles of blinatumomab.
  • Analyzed treatment responses via bone marrow and peripheral blood assessments using mass cytometry.
  • Studied gut microbiota and metabolites through specific sequencing and profiling techniques.
  • Achieved an overall response rate of 50% among initial 20 patients.
  • Demonstrated that specific baseline bone marrow blast percentages correlate with treatment response outcomes.
  • Showed enrichment of certain gut microbiota in responders, indicating a potential link to blinatumomab efficacy.
  • Identified distinct metabolomic profiles between complete responders and non-completers.

Cite This Study

Kato et al. (2025) studied this question.

synapsesocial.com/papers/69362f694fa91c937236deadhttps://doi.org/10.1182/blood-2025-1583
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparing the impact of blinatumomab therapy versus standard chemotherapy on the progression of relapsed/refractory pediatric B-ALL: a two-center retrospective cohort study2026
  2. 2Efficacy and safety of blinatumomab as frontline treatment for infant acute lymphoblastic leukemia2025
  3. 3Bispecific monoclonal antibody blinatumomab in the first-line therapy of B-lineage acute lymphoblastic leukemia in children and adolescents: interim results of the Russian Ministry of Health approbation protocol2024
  4. 4Blinatumomab for Pediatric High-Risk B-Cell Precursor Acute Lymphoblastic Leukemia: Safety, MRD Response and Survival in a Single-Center Retrospective Cohort2026
  5. 5Blinatumomab combined with low-dose chemotherapy and tyrosine kinase inhibitors as first-line induction for newly diagnosed Philadelphia chromosome-positive B-cell acute lymphoblastic leukemia: improved efficacy and reduced toxicity2025