Blinatumomab as bridging therapy in two children with B-cell acute lymphoblastic leukemia complicated by invasive fungal disease

LIU Xiao-Fei; TANG Xue; WANG Lu-Lu; WANG Ying; LIU Shi-Lin; ZHOU Gui-Chi; LI Tong-Hui; MAI Hui-Rong

doi:10.7499/j.issn.1008-8830.2306142

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Chinese Journal of Contemporary Pediatrics ›› 2023, Vol. 25 ›› Issue (12) : 1282-1286. DOI: 10.7499/j.issn.1008-8830.2306142

CLINICAL EXPERIENCE

Blinatumomab as bridging therapy in two children with B-cell acute lymphoblastic leukemia complicated by invasive fungal disease

LIU Xiao-Fei, TANG Xue, WANG Lu-Lu, WANG Ying, LIU Shi-Lin, ZHOU Gui-Chi, LI Tong-Hui, MAI Hui-Rong

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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.

Key words

B-cell acute lymphoblastic leukemia / Blinatumomab / Invasive fungal disease / Child

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LIU Xiao-Fei, TANG Xue, WANG Lu-Lu, WANG Ying, LIU Shi-Lin, ZHOU Gui-Chi, LI Tong-Hui, MAI Hui-Rong. Blinatumomab as bridging therapy in two children with B-cell acute lymphoblastic leukemia complicated by invasive fungal disease[J]. Chinese Journal of Contemporary Pediatrics. 2023, 25(12): 1282-1286 https://doi.org/10.7499/j.issn.1008-8830.2306142

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