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Efficacy Study of Blinatumomab Clean Up Early Residual Disease for Newly Diagnosed Pediatric B Lymphoblastic Leukemia

Phase 2
Recruiting
Conditions
B-Cell Lymphoblastic Leukemia
Interventions
Registration Number
NCT06607419
Lead Sponsor
Shanghai Jiao Tong University School of Medicine
Brief Summary

The goal of this clinical trial is to evaluate the efficacy of Blinatumomab in pediatric patient with newly diagnosed acute B-Lymphoblastic leukemia with poor response to early chemotherapy, i.e. day 19 MRD ≥ 0.1% (low-risk) or day 19 MRD ≥ 0.01% (intermediate-risk). The main question is:

• If the flow cytometric MRD negative (\<0.01%) rate and the NGS- MRD negative (\<0.0001%) rate at the end of induction for patients received Blinatumomab will be superior to historical control (D46MRD in the CCCG-ALL2020 protocol).

Participants will:

* Take 14 days full dose Blinatumomab;

* With bone marrow evaluated before and after Blinatumomab treatment.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
90
Inclusion Criteria
  • Age older than 1 month to younger than 18 years.
  • Diagnosis of acute lymphoblastic leukemia by bone marrow morphology.
  • Immunophenotyping: acute B-lymphoblastic leukemia;
  • Meet one of the following situations:

A. Provisional low-risk: D19MRD ≥ 0.1%; B. Provisional intermediate-risk: D19MRD ≥ 0.01%;

  • Subjects in the sytudy group or their guardians must be able to understand and accept the informed consent approved by the Ethics Committee
Exclusion Criteria
  • sIgM+;
  • ALL evolved from chronic myeloid leukemia (CML);
  • Down's syndrome, or major congenital or hereditary disease with organ dysfunction;
  • Other secondary leukemias;
  • CNS involvement;
  • History of epilepsy; or convulsions within the last month;
  • Known underlying congenital immunodeficiency or metabolic disease;
  • Congenital heart disease with cardiac insufficiency;
  • Treated with glucocorticoids for ≥14 days, or ABL kinase inhibitors for > 7 days within one month before enrollment, or any chemotherapy or radiotherapy within 3 months before enrollment (except for emergency radiotherapy to relieve airway compression);
  • Initial diagnosis of high risk;
  • D46MRD ≥1%.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
BlinatumomabBlinatumomabPatients in this group should receive Blinatumomab
Primary Outcome Measures
NameTimeMethod
The flow cytometric MRDFrom the date of Blinatumomab completion to one week after its treatment course

The flow cytometric MRD negative (\<0.01%) rate at the end of induction for patients received Blinatumomab will superior to historical control (D46MRD in the CCCG-ALL2020 protocol)

The NGS- MRDFrom the date of Blinatumomab completion to one week after its treatment course

The NGS- MRD negative (\<0.0001%) rate at the end of induction for patients received Blinatumomab will superior to historical control (D46MRD in the CCCG-ALL2020 protocol)

Secondary Outcome Measures
NameTimeMethod
5-year EFS5 years since the last recruited patient completed Blinatumomab.

The 5-year EFS of study group was significantly higher than that of the control group.

Adverse eventsFrom day 19 of induction therapy until the start of the second high-dose methotrexate regimen.

Comparison of adverse events in study and control groups

Healthcare costsSix-month since window phase

Comparison of healthcare costs in study and control groups

Trial Locations

Locations (4)

Anhui Provincial Children's Hospital

🇨🇳

Hefei, Anhui, China

Fujian Children's Hospital

🇨🇳

Fuzhou, Fujian, China

Shanghai Children's Medical center

🇨🇳

Shanghai, Shanghai, China

Ningbo Women and Children's Hospital

🇨🇳

Ningbo, Zhejiang, China

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