Outcome of CD20-positive Adult B-cell Acute Lymphoblastic Leukemia and the Impact of Rituximab Therapy

Alduailej, Hanan; Kanfar, Solaf; Bakhit, Khalid; Raslan, Heba; Alsaber, Arwa; Bashawri, Layla; Aldayel, Afra; Alanezi, Khalid

doi:10.1016/j.clml.2020.04.008

Cited by 6 publications

(8 citation statements)

References 15 publications

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“…Patients who received any CD-targeted immunotherapy in the induction or salvage therapy also had 1.70-fold odds of obtaining CR compared to those who did not receive any immunotherapy (95% CI, 1.07-2.69; I 2 , 79%). 17 -19,26 -28,31 -33,39,40 In addition, the rate of achieving MRD negativity was significantly higher for the patients who received any immunotherapy (pooled OR, 2.98; 95% CI, 1.17-7.58; I 2 , 90% 17,19,25,26,30,32 ; Figure 2A-D).…”

Section: Resultsmentioning

confidence: 97%

“…The OS rates were reported as a 6-month rate by 1 study, 18 a 1-year rate by 2 studies, 27,28 a 2-year rate by 3 studies, 19,25,29 a 3-year rate by 3 studies, 30,31,33 and a 4-year rate by 1 study. 17 RFS rates were reported as a 6-month rate by 1 study, 18 a 2-year rate by 2 studies, 25,29 a 3-year rate by 3 studies, 26,30,33 and a 4-year rate by 1 study.…”

Section: Resultsmentioning

confidence: 99%

“…140 of those were discarded as they lacked the outcomes of interest. Finally, 14 eligible studies (5 RCTs [17][18][19]25,26 and 9 retrospective cohort studies [27][28][29][30][31][32][33]39,40 ) fulfilled the eligibility criteria for our meta-analysis. Of those, 7 compared blinatumomab (a CD3/CD19 bispecific T-cell engager) to chemotherapy 18,25,[27][28][29]39,40 ; 4 compared rituximab (an anti-CD20 monoclonal antibody) to chemotherapy, 17,26,30,31 1 compared epratuzumab (an anti-CD22 monoclonal antibody) to chemotherapy 32 ; and 2 compared (InO; an anti-CD22 antibody-drug conjugate) to chemotherapy 19,33 ; Figure 1 illustrates the full literature review and selection process.…”

Section: Search Resultsmentioning

confidence: 99%

“…Patients who received rituximab in the induction or salvage therapy had significantly greater rates of OS (pooled OR, 2.27; 95% CI, 1.24-4.16; I 2 , 36%) 17,30,31 and RFS (pooled OR, 1.87; 95% CI, 1.07-3.25; I 2 , 72%). 17,26,30 However, although the odds of achieving CR (pooled OR, 1.40; 95% CI, 0.81-2.43; I 2 , 0%) 17,26,31 and MRD negativity (pooled OR, 1.48; 95% CI, 0.72-3.03; I 2 , 72%) 17,26,30 were also better, they did not reach statistical significance ( Figure 5A-D ) .…”

Section: Resultsmentioning

confidence: 99%

“…13,14,[20][21][22] For the OS and RFS rates, Technology in Cancer Research & Treatment the time of interest was the longest of 6 months, 1 year, 2 years, 3 years, or 4 years with available results in each study. [17][18][19][25][26][27][28][29][30][31][32][33] The MRD negativity rate was defined as either <0.01% bone marrow lymphoblasts, confirmed by cytometry or immunoglobulin, or T-cell receptor gene rearrangements in bone marrow samples. 17,19,25,26,30,32 Finally, febrile neutropenia was defined as an absolute neutrophil count <1.0 Â 10 9 /L, and either a single temperature >38.3 C or a sustained temperature of at least 38.0 C for more than 1 hour, according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (version 4.0).…”

Section: Definitions Of Outcomesmentioning

confidence: 99%

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Efficacy of Targeted Immunotherapy as Induction or Salvage Therapy in Acute Lymphoblastic Leukemia: A Systematic Review and Meta-Analysis

Ponvilawan

Vittayawacharin

Tunsing

et al. 2021

Technol Cancer Res Treat

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Background: Monoclonal antibodies targeting cluster of differentiation (CD) proteins have been incorporated into standard treatments for multiple types of hematologic malignancies, including acute lymphoblastic leukemia (ALL). This systematic review and meta-analysis investigated the efficacy of using CD-targeted antibodies for ALL. Materials and Methods: The EMBASE and MEDLINE databases were searched for research papers using immunotherapy- and ALL-related terms from inception to July 2021. Eligible studies were randomized, controlled trials (RCTs) or cohort studies in which ALL patients received CD-targeted immunotherapy or conventional chemotherapy as the induction or salvage therapy. The reports had to report our primary outcomes of interest: overall survival (OS), relapse-free survival (RFS), or complete remission (CR), with the patient number for each outcome. The effect estimates with 95% confidence interval (CI) from each study were combined to calculate the pooled-effect estimate, using the Hantel-Maenszel method. Results: Five RCTs and 9 retrospective cohort studies were eligible for the meta-analysis. ALL patients given CD-targeted immunotherapy in the induction or salvage therapy had significantly higher OS and RFS rates than those administered conventional chemotherapy only, with pooled odds ratios (OR) of 2.11 (95% CI, 1.76-2.53; I2, 0%) and 2.25 (95% CI, 1.62-3.14; I2, 61%), respectively. The rates of achieving CR and minimal residual disease negativity were also higher for the immunotherapy group, with pooled ORs of 1.70 (95% CI, 1.07-2.69; I2, 79%) and 2.98 (95% CI, 1.17-7.58; I2, 90%), while developing less risk for febrile neutropenia (pooled OR, 0.22; 95% CI, 0.08-0.58; I2, 84%). Subgroup analyses revealed that all antibody types yielded dramatically better OS rates than those for patients administered chemotherapy alone. Conclusions: The ALL patients receiving CD-targeted immunotherapy as induction or salvage therapy had significantly higher response rates and survival outcomes, as well as lower odds of acquiring febrile neutropenia, than the patients given conventional chemotherapy.

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