Abstract This article reports two cases of children with B-cell acute lymphoblastic leukemia (B-ALL) complicated by invasive fungal disease (IFD) who received bridging treatment using blinatumomab. Case 1 was a 4-month-old female infant who experienced recurrent high fever and limb weakness during chemotherapy. Blood culture was negative, and next-generation sequencing (NGS) of peripheral blood, bronchoalveolar lavage fluid, and cerebrospinal fluid were all negative. Chest CT and cranial MRI revealed obvious infection foci. Case 2 was a 2-year-old male patient who experienced recurrent high fever with multiple inflammatory masses during chemotherapy. Candida tropicalis was detected in peripheral blood and abscess fluid using NGS, while blood culture and imaging examinations showed no obvious abnormalities. After antifungal and blinatumomab therapy, both cases showed significant improvement in symptoms, signs, and imaging, and B-ALL remained in continuous remission. The report indicates that bridging treatment with blinatumomab in children with B-ALL complicated by IFD can rebuild the immune system and control the underlying disease in the presence of immunosuppression and severe fungal infection.
LIU Xiao-Fei,TANG Xue,WANG Lu-Lu et al. Blinatumomab as bridging therapy in two children with B-cell acute lymphoblastic leukemia complicated by invasive fungal disease[J]. CJCP, 2023, 25(12): 1282-1286.
LIU Xiao-Fei,TANG Xue,WANG Lu-Lu et al. Blinatumomab as bridging therapy in two children with B-cell acute lymphoblastic leukemia complicated by invasive fungal disease[J]. CJCP, 2023, 25(12): 1282-1286.
Goebeler ME, Bargou R. Blinatumomab: a CD19/CD3 bispecific T cell engager (BiTE) with unique anti-tumor efficacy[J]. Leuk Lymphoma, 2016, 57(5): 1021-1032. PMID: 27050240. DOI: 10.3109/10428194.2016.1161185.
Pawinska-Wasikowska K, Wieczorek A, Balwierz W, et al. Blinatumomab as a bridge therapy for hematopoietic stem cell transplantation in pediatric refractory/relapsed acute lymphoblastic leukemia[J]. Cancers (Basel), 2022, 14(2): 458. PMID: 35053619. PMCID: PMC8773605. DOI: 10.3390/cancers14020458.
Ampatzidou M, Kattamis A, Baka M, et al. Insights from the Greek experience of the use of blinatumomab in pediatric relapsed and refractory acute lymphoblastic leukemia patients[J]. Neoplasma, 2020, 67(6): 1424-1430. PMID: 32701357. DOI: 10.4149/neo_2020_200128N93.
Brown PA, Ji L, Xu X, et al. Effect of postreinduction therapy consolidation with blinatumomab vs chemotherapy on disease-free survival in children, adolescents, and young adults with first relapse of B-cell acute lymphoblastic leukemia: a randomized clinical trial[J]. JAMA, 2021, 325(9): 833-842. PMID: 33651090. PMCID: PMC7926290. DOI: 10.1001/jama.2021.0669.
Halford Z, Coalter C, Gresham V, et al. A systematic review of blinatumomab in the treatment of acute lymphoblastic leukemia: engaging an old problem with new solutions[J]. Ann Pharmacother, 2021, 55(10): 1236-1253. PMID: 33435716. DOI: 10.1177/1060028020988411.
Locatelli F, Zugmaier G, Rizzari C, et al. Effect of blinatumomab vs chemotherapy on event-free survival among children with high-risk first-relapse B-cell acute lymphoblastic leukemia: a randomized clinical trial[J]. JAMA, 2021, 325(9): 843-854. PMID: 33651091. PMCID: PMC7926287. DOI: 10.1001/jama.2021.0987.
Cornely OA, Alastruey-Izquierdo A, Arenz D, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium[J]. Lancet Infect Dis, 2019, 19(12): e405-e421. PMID: 31699664. PMCID: PMC8559573. DOI: 10.1016/S1473-3099(19)30312-3.
Yeoh DK, Haeusler GM, McMullan BJ, et al. Antifungal use in children with acute leukaemia: state of current evidence and directions for future research[J]. J Antimicrob Chemother, 2022, 77(6): 1508-1524. PMID: 35301533. DOI: 10.1093/jac/dkac060.
Contreras CF, Higham CS, Behnert A, et al. Clinical utilization of blinatumomab and inotuzumab immunotherapy in children with relapsed or refractory B-acute lymphoblastic leukemia[J]. Pediatr Blood Cancer, 2021, 68(1): e28718. PMID: 33098744. PMCID: PMC7688575. DOI: 10.1002/pbc.28718.
