ArticleBlood advances2025
TP53 mutations are associated with CD19- relapse and inferior outcomes after blinatumomab in adults with ALL.
Article in Blood advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Comparative efficacy and long-term survival of CD19/22 versus CD19 CAR-T immunotherapy in Relapsed/Refractory B-ALL with TP53 alterations.Journal of translational medicine · 2026Trial
- Bridging therapy in pediatric and AYA patients under 25 years with relapsed/refractory B-ALL undergoing anti-CD19 CAR-T therapy: a multicenter retrospective study by the Spanish group GETH-TC.Bone marrow transplantation · 2026Article
- Clinical Implications of CD19-Negative Relapse Following CD19-Directed Therapy in B-Cell Acute Lymphoblastic Leukemia.American journal of hematology · 2026Article
- High-risk features in adult patients with B-cell acute lymphoblastic leukemia: redefining risk in the era of targeted immunotherapy.Blood research · 2026Review
- Plasticity under pressure: biology and detection of lineage switch in acute leukemia.Leukemia · 2026Review
- Antigen Pressure, Clonal Evolution, and Lineage Plasticity in B-Cell Acute Lymphoblastic Leukemia: Resistance Biology in the Immunotherapy Era.Current hematologic malignancy reports · 2026Review
- Predictors of Relapse and Post-Relapse Outcomes After Frontline Blinatumomab in Philadelphia Chromosome-Negative B-ALL.American journal of hematology · 2026Article
- CD22-targeted immunotherapy for B-cell acute lymphoblastic leukemia progressing following CD19-targeted immunotherapy.NPJ precision oncology · 2026Article
- Immunotherapy in the up-front treatment of adult B-cell precursor acute lymphoblastic leukemia: when, how, who?Blood advances · 2026Review
- Article
- Clinical and molecular characterization of TP53-mutant acute lymphoblastic leukemia in adults.Blood cancer journal · 2025Article
- Blinatumomab use in pediatric B-ALL: where are we now?Blood advances · 2025Review
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Authors and funding
30 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
abstractDespite the success of the CD19 × CD3 T-cell engager blinatumomab in B-cell acute lymphoblastic leukemia (B-ALL), treatment failure is common and can manifest with antigen loss and extramedullary disease (EMD) relapse. To understand the impact of leukemia genetics on outcomes, we reviewed 267 adult patients with B-ALL treated with blinatumomab and used next-generation sequencing to identify molecular alterations. Patients received blinatumomab for relapsed/refractory (R/R) disease (n = 150) and minimal residual disease (MRD; n = 88), upfront as induction (n = 10) or as consolidation in MRD-negative state (n = 19). In the overall cohort, 50 patients (19%) had Philadelphia chromosome (Ph)-positive ALL, 80 (30%) had Ph-like ALL, 35 (13%) had TP53 mutations (TP53m), 7 (3%) had KMT2A rearrangement, and 8 (3%) had PAX5 alterations. For patients treated for R/R ALL, the overall complete remission (CR)/CR with incomplete hematological recovery (CRi) rate was 59%. Only pretreatment high disease burden (P < .01) and active EMD (P < .01) were associated with inferior CR/CRi rate. Of 169 patients in CR/CRi after blinatumomab, 79 (47%) patients relapsed, including 22 (28%) with CD19- and 54 (68%) with CD19+ relapse. In multivariable analysis, TP53m was associated with an increased risk of CD19- relapse (hazard ratio [HR], 6.84; 95% confidence interval [CI], 2.68-17.45; P < .01). Post-blinatumomab allogeneic stem cell transplantation consolidation was associated with a lower risk of CD19- relapse (HR, 0.10; 95% CI, 0.03-0.37; P < .01) and EMD relapse (HR, 0.36; 95% CI, 0.18-0.73; P < .01). In conclusion, leukemia genetics may predict patterns of blinatumomab failure, with TP53m associated with CD19- relapse.
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