Follow guidelines for safe delivery of blinatumomab in leukaemia patients: study

Institutional guidelines in place are necessary to facilitate a safe and effective delivery of blinatumomab in patients with relapsed/refractory acute lymphoblastic leukaemia, suggests a study.

The investigators examined the effect of blinatumomab toxicities on drug therapy modifications in an intended 28-day course of blinatumomab therapy. Included in the analysis were patients with acute lymphoblastic leukaemia who received blinatumomab at the University of Maryland Marlene & Stewart Greenebaum Comprehensive Cancer Center from 1 March 2015 to 30 April 2018.

Primary endpoints were the frequency and severity of blinatumomab toxicities leading to drug therapy modifications, while secondary endpoints included the frequency and duration of modifications as well as the total dose and duration of therapy received.

Twenty-three patients met the eligibility criteria, of whom 78 percent experienced cytokine release syndrome or neurotoxicity. In total, 18 drug therapy modifications occurred due to toxicity, with a median interruption time of 9 hours.

Treatment with blinatumomab was continued for the majority of patients with grade 1 or 2 neurotoxicity and discontinued for those with grade 3 or 4 events. The median number of days of therapy delivered was 28 days (range, 27–35).

A median of 2 hours (range, 0–16) of therapy or 0.2 percent (range, 0–2.4) of a total 28-day cycle was lost due to transition of care.

“This retrospective study demonstrates a single-centre experience with blinatumomab toxicity management and appropriate delivery of drug during transitions of care,” the investigators noted.