{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T17:45:53Z","timestamp":1790444753665,"version":"4.1.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T00:00:00Z","timestamp":1681776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81970138, 82270165, 82200249"],"award-info":[{"award-number":["81970138, 82270165, 82200249"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018592","name":"\u201c333 Project\u201d of Jiangsu Province","doi-asserted-by":"publisher","award":["BE2021649"],"award-info":[{"award-number":["BE2021649"]}],"id":[{"id":"10.13039\/501100018592","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010023","name":"Natural Science Research of Jiangsu Higher Education Institutions of China","doi-asserted-by":"publisher","award":["BK20221235, BK20210091"],"award-info":[{"award-number":["BK20221235, BK20210091"]}],"id":[{"id":"10.13039\/501100010023","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>The treatment of B-cell acute lymphoblastic leukemia (B-ALL) with central nervous system (CNS) involvement poses a significant clinical challenge because most chemotherapeutic agents exhibit weak permeability to the blood-brain barrier (BBB). In addition, current anti-CNS leukemia treatments often bring short or long-term complications. Immunotherapy including chimeric antigen T-cell therapy and bispecific antibody have shown profound treatment responses in relapsed\/refractory B-ALL. However, there is a lack of data on the efficacy of bispecific antibody in treating B-ALL with CNS involvement. Here, we report two ALL patients with CNS leukemia who received blinatumomab. Case 1 was diagnosed with chronic myeloid leukemia in lymphoid blast phase. The patient developed CNS leukemia and bone marrow relapse during the treatment with dasatinib. Case 2 was diagnosed with B-ALL and suffered early hematologic relapse and cerebral parenchyma involvement. After treatment with one cycle of blinatumomab, both patients achieved complete remission in the bone marrow and CNS. Furthermore, this is the first report on the efficacy of blinatumomab in treating CNS leukemia with both of the cerebral spinal fluid and the cerebral parenchymal involvement. Our results suggest that blinatumomab might be a potential option for the treatment of CNS leukemia.<\/jats:p>","DOI":"10.3389\/fimmu.2023.1181620","type":"journal-article","created":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T05:17:14Z","timestamp":1681795034000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Case Report: Blinatumomab therapy for the treatment of B-cell acute lymphoblastic leukemia patients with central nervous system infiltration"],"prefix":"10.3389","volume":"14","author":[{"given":"Han-Yu","family":"Cao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song-Bai","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Jie","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong-Sheng","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong-Tong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Ling","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si-Man","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai-Ping","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng-Li","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2019.1605071","article-title":"Recent advances in the treatment of acute lymphoblastic leukemia","volume":"60","author":"Rafei","year":"2019","journal-title":"Leuk Lymphoma"},{"key":"B2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1080\/10428194.2017.1326597","article-title":"Managing CNS disease in adults with acute lymphoblastic leukemia","volume":"59","author":"Larson","year":"2018","journal-title":"Leukemia lymphoma"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s10555-020-09848-z","article-title":"Involvement of the central nervous system in acute lymphoblastic leukemia: opinions on molecular mechanisms and clinical implications based on recent data","volume":"39","author":"Lenk","year":"2020","journal-title":"Cancer Metastasis Rev"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-05-018192","article-title":"Outcome of 609 adults after relapse of acute lymphoblastic leukemia (ALL); an MRC UKALL12\/ECOG 2993 study","volume":"109","author":"Fielding","year":"2007","journal-title":"Blood"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01714-x","article-title":"Central nervous system involvement in childhood acute lymphoblastic leukemia: challenges and solutions","volume":"36","author":"Thastrup","year":"2022","journal-title":"Leukemia"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1126\/science.1158545","article-title":"Tumor regression in cancer patients by very low doses of a T cell-engaging antibody","volume":"321","author":"Bargou","year":"2008","journal-title":"Sci (New York NY)"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1609783","article-title":"Blinatumomab versus chemotherapy for advanced acute lymphoblastic leukemia","volume":"376","author":"Kantarjian","year":"2017","journal-title":"New Engl J Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2016272","article-title":"Dasatinib-blinatumomab for ph-positive acute lymphoblastic leukemia in adults","volume":"383","author":"Fo\u00e0","year":"2020","journal-title":"New Engl J Med"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1200\/PO.21.00039","article-title":"Rapid and deep remission induced by blinatumomab for CD19-positive chronic myeloid leukemia in lymphoid blast phase","volume":"5","author":"Patel","year":"2021","journal-title":"JCO Precis Oncol"},{"key":"B10","unstructured":"NCCN clinical practice guidelines in oncology: acute lymphoblastic leukemia\n            BrownPA\n            ShahB\n            AdvaniA\n            AounP\n            BoyerMW\n            BurkePW"},{"key":"B11","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.jphys.2013.12.012","article-title":"National institutes of health stroke scale (NIHSS)","volume":"60","author":"Kwah","year":"2014","journal-title":"J Physiother"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022015850","article-title":"International consensus classification of myeloid neoplasms and acute leukemias: integrating morphologic, clinical, and genomic data","volume":"140","author":"Arber","year":"2022","journal-title":"Blood"},{"key":"B13","doi-asserted-by":"publisher","first-page":"13331","DOI":"10.1038\/ncomms13331","article-title":"Genomic analyses identify recurrent MEF2D fusions in acute lymphoblastic leukaemia","volume":"7","author":"Gu","year":"2016","journal-title":"Nat Commun"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.66.5547","article-title":"MEF2D-BCL9 fusion gene is associated with high-risk acute b-cell precursor lymphoblastic leukemia in adolescents","volume":"34","author":"Suzuki","year":"2016","journal-title":"J Clin Oncol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-022-01680-9","article-title":"Olverembatinib: first approval","volume":"82","author":"Dhillon","year":"2022","journal-title":"Drugs"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1038\/nature14432","article-title":"Structural and functional features of central nervous system lymphatic vessels","volume":"523","author":"Louveau","year":"2015","journal-title":"Nature"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.tranon.2020.100838","article-title":"Successful application of anti-CD19 CAR-T therapy with IL-6 knocking down to patients with central nervous system b-cell acute lymphocytic leukemia","volume":"13","author":"Chen","year":"2020","journal-title":"Trans Oncol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021013733","article-title":"Efficacy and safety of CD19-specific CAR T cell-based therapy in b-cell acute lymphoblastic leukemia patients with CNSL","volume":"139","author":"Qi","year":"2022","journal-title":"Blood"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.2012.126","article-title":"Drug transport across the blood-brain barrier","volume":"32","author":"Pardridge","year":"2012","journal-title":"J Cereb Blood Flow Metab"},{"key":"B20","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1158\/0008-5472.Can-19-1131","article-title":"Adhesion of T cells to endothelial cells facilitates blinatumomab-associated neurologic adverse events","volume":"80","author":"Klinger","year":"2020","journal-title":"Cancer Res"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2023.1181620\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T05:17:23Z","timestamp":1681795043000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2023.1181620\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,18]]},"references-count":20,"alternative-id":["10.3389\/fimmu.2023.1181620"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2023.1181620","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,18]]},"article-number":"1181620"}}