{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T23:03:28Z","timestamp":1784847808156,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"16","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Blinatumomab has been approved for the treatment of pediatric B\u2010cell acute lymphoblastic leukemia (B\u2010ALL). This study aimed to investigate the association between leukemia burden and the efficacy of blinatumomab in real\u2010world applications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A real\u2010world study was conducted by enrolling patients aged 0\u201318\u2009years who were diagnosed with CD19\u2010positive B\u2010ALL and treated with blinatumomab between January 2021 and May 2023 from 14 centers in China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 304 patients were enrolled in this analysis. In the patients with &gt;\u20095% blasts before blinatumomab (non\u2010complete remission, NCR group), 75.9% achieved complete remission (CR) and 69.0% of the NCR patients achieved minimal residual disease (MRD) negativity. Among the patients with \u2264\u20095% blasts but multiparametric flow cytometry MRD (MFC MRD) positive (MRD+ group), 98.9% achieved MRD negativity. Of the MFC MRD negative patients (MRD\u2212 group), the quantitative polymerase chain reaction MRD (qPCR MRD) and next\u2010generation sequencing MRD (NGS MRD) clearance rate was 60.0% (12\/20) and 65.5% (19\/29), respectively. Additionally, patients in the MRD\u2212 and MRD+ groups had significantly better outcomes than those in the NCR group, with 30\u2010month overall survival (OS) rates of 95.3% (95% CI: 91.4%\u201399.3%), 91.2% (95% CI: 85.0%\u201397.8%), and 77.6% (95% CI: 67.4%\u201389.4%), respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and 30\u2010month event\u2010free survival (EFS) rates of 93.9% (95% CI: 89.6%\u201398.3%), 90.8% (95% CI: 85.0%\u201397.1%), and 56.7% (95% CI: 41.0%\u201378.6%), respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In this study, 41.4% of patients experienced grade \u2265\u20093 adverse events (AEs), with hematological toxicity being the most common (33.2%). The severe adverse events, such as cytokine release syndrome (CRS) and neurotoxicity, occurred at a low rate, particularly grade \u2265\u20093, at 3.6% and 2.6%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, these results indicate that blinatumomab is effective and well tolerated. Patients with a lower leukemia burden before blinatumomab administration tend to have better OS and EFS with fewer AEs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.71159","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T09:42:12Z","timestamp":1755596532000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Leukemia Burden Impacts the Efficacy and Toxicity of Blinatumomab in Pediatric B\u2010Cell Acute Lymphoblastic Leukemia"],"prefix":"10.1002","volume":"14","author":[{"given":"Weiling","family":"Yan","sequence":"first","affiliation":[{"name":"Department of Hematology &amp; Oncology, Children's Hospital, Zhejiang University School of Medicine National Clinical Research Center for Child Health  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoyan","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Hematology Children's Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjin","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Hematology &amp; Oncology Xi'an Children's Hospital  Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology Zhujiang Hospital, Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunyan","family":"He","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The First Affiliated Hospital of Guangxi Medical University  Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dunhua","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Sun Yat\u2010Sen Memorial Hospital, Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenting","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Hematology &amp; Oncology, Shanghai Children's Medical Center School of Medicine, Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Hematology Shenzhen Children's Hospital  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6416-312X","authenticated-orcid":false,"given":"Ming","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Hematology Wuhan Children's Hospital  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Hematology Henan (Zhengzhou) Children's Hospital  Zhengzhou Henan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyu","family":"Yang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology &amp; 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