{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T04:42:45Z","timestamp":1778560965046,"version":"3.51.4"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"\n Background<\/jats:title>\n Precursor B-cell acute lymphoblastic leukemia (pre-B ALL) is the most common pediatric cancer worldwide, with cure rates exceeding 85% in high-income countries. However, in *Mexico*, event-free survival (EFS) during first remission remains below 65%. Children with *relapsed or refractory CD19+ pre-B ALL* have dismal prognoses and limited therapeutic options. This study evaluated the efficacy and safety of *blinatumomab* as a bridge to allogeneic hematopoietic stem cell transplantation (HSCT), including *haploidentical HSCT*, in this high-risk population.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This multicenter, prospective interventional study was conducted between February 2017 and December 2022 across four pediatric oncology centers in Mexico. Fifty-four patients (aged 8 months to 18 years) with refractory or high-risk relapsed CD19+ pre-B ALL received one or two cycles of *blinatumomab*. Responders were consolidated with allogeneic HSCT. Primary endpoints included remission rates and clinical factors associated with response; secondary endpoints were blinatumomab-related toxicity, overall survival (OS), EFS, and transplant outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 54 patients, 24 (44.5%) received one cycle, achieving a molecular complete remission rate of 75%. Thirty (55.5%) received two cycles, with 73.3% reaching deep remission (p = 0.89). Forty-one patients (76%) proceeded to HSCT, including 70% who received *haploidentical transplants*. Thirteen did not undergo HSCT due to refractory disease (n = 8) or partial response (n = 5). At 60 months, transplanted patients achieved an OS of 82% and EFS of 68%, with the best survival in matched related donor recipients (100%) versus haploidentical (58%). *Blinatumomab* demonstrated a favorable safety profile with no treatment-related mortality.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Blinatumomab followed by haploidentical HSCT offers an effective and feasible therapeutic strategy for *relapsed or refractory CD19+ pre-B ALL* in *Mexico*, improving long-term survival in resource-limited settings.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fonc.2025.1653329","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T05:16:50Z","timestamp":1763011010000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Blinatumomab-induced remission followed by haploidentical transplantation in pediatric relapsed\/refractory pre-B ALL: a multicenter study in Mexico"],"prefix":"10.3389","volume":"15","author":[{"given":"Alberto","family":"Olaya-Vargas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haydee","family":"Salazar-Rosales","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yadira","family":"Melchor-Vidal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mart\u00edn","family":"P\u00e9rez-Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annecy","family":"Herver-Olivares","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerardo","family":"L\u00f3pez-Hern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nideshda","family":"Ram\u00edrez-Uribe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesar","family":"Galv\u00e1n-D\u00edaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irlanda","family":"Campos-P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar","family":"Cubria-Ju\u00e1rez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angeles","family":"Del 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Gallardo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ignacio","family":"Mora-Maga\u00f1a","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaime","family":"Shalkow-Klincovstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1400972","article-title":"Acute lymphoblastic leukemia in children","volume":"373","author":"Hunger","year":"2015","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.37.8018","article-title":"Improved survival for children and adolescents with acute lymphoblastic leukemia between 1990 and 2005: a report from the children\u2019s oncology group","volume":"30","author":"Hunger","year":"2012","journal-title":"J Clin 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