Jonathan E. Brammer, MD, assistant professor, internal medicine, The Ohio State University Comprehensive Cancer Center—–James, discusses the importance of achieving minimal residual disease (MRD) negativity in relapsed/refractory acute lymphoblastic leukemia (ALL).

MRD is an important predictor of outcomes in both B-cell ALL and T-cell ALL, says Brammer. The majority of patients who are MRD positive after induction chemotherapy will relapse.

The phase II BLAST study evaluated the bispecific T-cell engager blinatumomab (Blincyto). The drug received regulatory approval in 2018 for the treatment of adult and pediatric patients with MRD-positive B-cell precursor ALL. The study confirmed that blinatumomab is effective in eradicating MRD in patients who received at least 3 cycles of prior treatment. Notably, many of these patients were subsequently eligible to receive stem cell transplantation, concludes Brammer.