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December 8, 2025Blood

Optimal therapy for pediatric B-ALL in first relapse: Comparative effectiveness of blinatumomab to hematopoietic cell transplantation versus CD19 CAR T cell therapy

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Authors

RMRegina M. MyersYLYimei LiAHAlex Hoover

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Overview

Retrospective analysis shows comparable overall survival with blinatumomab or hematopoietic cell transplantation in pediatric patients with B-ALL relapse, suggesting viable treatment options.

Key Points

  • To compare the effectiveness of blinatumomab, hematopoietic cell transplantation, and CAR T cell therapy in pediatric B-ALL first relapse patients.
  • Conducted a multicenter retrospective study from 2018-2022
  • Included patients <30 years with first relapse therapy
  • Emulated an open-label trial comparing blinatumomab/HCT to CART
  • Used Cox regression models for adjusting outcomes
  • Analyzed overall survival from end of reinduction.
  • Median time to relapse was 31 months, 4-year overall survival was 64%
  • Survival rates varied for early versus late relapses, with only 29% for relapses <18 months
  • Unadjusted OS comparable between blinatumomab/HCT and CART, suggesting CART may be a viable alternative

Cite This Study

Myers et al. (2025) studied this question.

synapsesocial.com/papers/693624dd4fa91c937236d271https://doi.org/10.1182/blood-2025-3339
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1CD19 CAR T cell therapy is an effective strategy for first CNS relapse in pediatric b ALL2025 · 4 citations
  2. 2Humanized CD19 chimeric antigen receptor (CAR) T-cell therapy for high-risk and post-CAR relapse of B-cell acute lymphoblastic leukemia2025 · 1 citations
  3. 3Predictors of survival with and without allogeneic stem cell transplantation after first salvage therapy with blinatumomab and/or inotuzumab ozogamicin for Relapsed/Refractory B-cell acute lymphoblastic leukemia2025 · 1 citations
  4. 4Large B-cell lymphoma following CD19-directed CART-cell therapy failure: Impact of CAR construct on disease features and outcomes of subsequent therapies2025
  5. 5Selecting the optimal bridging therapy for B-ALL: A multicenter comparison of blinatumomab, inotuzumab ozogamicin, and CAR-T prior to allo-HSCT2025