Prof Anthony Moorman speaks to ecancer about his study that evaluated outcomes in children and young people with chemotherapy-intolerant or resistant disease to develop a blinatumomab-specific risk model.
Blinatumomab is increasingly used as a chemotherapy-replacement strategy in B-cell acute lymphoblastic leukaemia, but its impact across different biological subgroups has remained unclear.

Results showed that survival outcomes were comparable to historical chemotherapy-treated cohorts, with high overall survival and low relapse rates. Importantly, traditional risk factors such as age, white cell count, and baseline disease characteristics did not predict relapse in this setting.

Instead, early response to blinatumomab particularly measurable residual disease after the first cycle along with specific genetic alterations including IKZF1plus and DUX4 rearrangements, were the strongest predictors of relapse.

These factors were integrated into the UKBlinPredict model, which successfully identified high- and low-risk groups with markedly different relapse outcomes.

Prof Moorman says that these findings highlight a shift toward response- and biology-driven risk stratification, supporting more personalized treatment approaches following frontline blinatumomab in B-ALL.