较低的基线骨髓爆发百分比（bBMB%）与接受布利那单抗治疗的B细胞急性淋巴细胞白血病（B-ALL）患者的良好预后有关。本分析的目的是研究bBMB%与复发/难治性（R/R）B-ALL治疗效果之间的关联。对R/R B-ALL的布利那单抗的五项试验的数据进行了汇总分析。患者分为三组：第1组，≥50％ bBMBs；第2组，≥25％至<50％ bBMBs；第3组，≥5％至<25％ bBMBs。比较组间的反应和生存结果。分析了683名患者的数据（166名儿童，517名成年人）。总体而言，与第1组（参考）相比，第2组和第3组的患者实现完全缓解（CR）（比值比例[OR]，分别为3.50 [95％置信区间（CI），2.23-5.48]和3.93 [95％ CI，2.50-6.18]，p <0.001）和最小/可测量残留疾病反应（OR，分别为2.61和3.37，p <0.001）的可能性显著升高。与第1组相比，第2组和第3组的死亡风险降低了37％和46％（危险比[HR]，分别为0.63和0.54，p <0.001），事件（复发或死亡）的风险降低了41％和43％（HR，分别为0.59和0.57，p <0.001）。组之间的反应或生存结果没有显著差异。将bBMB％降低到<50％的9名患者中有7名在布利那单抗治疗下实现了CR。任何bBMB％ <50％与R/R B-ALL布利那单抗治疗的疗效改善有关。© 2023 Amgen和作者。癌症由Wiley Periodicals LLC代表美国癌症协会出版。

A lower baseline bone marrow blast percentage (bBMB%) is associated with better outcomes in patients with B-cell acute lymphoblastic leukemia (B-ALL) receiving blinatumomab. The objective of this analysis was to investigate the association between bBMB% and treatment outcomes in relapsed/refractory (R/R) B-ALL.Data from five trials of blinatumomab for R/R B-ALL were pooled for analyses. Patients were placed in one of three groups: group 1, ≥50% bBMBs; group 2, ≥25% to <50% bBMBs; group 3, ≥5% to <25% bBMBs. Response and survival outcomes were compared between groups.Data from 683 patients (166 pediatric, 517 adult) were analyzed. Collectively, patients in groups 2 and 3 had significantly higher odds of achieving a complete remission (CR) (odds ratio [OR], 3.50 [95% confidence interval (CI), 2.23-5.48] and 3.93 [95% CI, 2.50-6.18], respectively; p < .001) and minimal/measurable residual disease response (OR, 2.61 and 3.37, respectively; p < .001) when compared with group 1 (reference). Groups 2 and 3 had a 37% and 46% reduction in the risk of death (hazard ratio [HR], 0.63 and 0.54, respectively; p < .001) and a 41% and 43% reduction in the risk of an event (relapse or death) (HR, 0.59 and 0.57, respectively; p < .001) compared with group 1. No significant differences in response or survival outcomes were observed between groups 2 and 3. Seven of nine patients whose bBMB% was lowered to <50% with dexamethasone achieved CR with blinatumomab.Any bBMB% <50% was associated with improved efficacy following blinatumomab treatment for R/R B-ALL.© 2023 Amgen and The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.