{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T02:33:37Z","timestamp":1791686017155,"version":"4.3.4"},"reference-count":67,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Blinatumomab, a bispecific T-cell engager (BiTE), has shown substantial efficacy in treating both relapsed\/refractory (R\/R) Philadelphia chromosome (Ph)-positive and Ph-negative acute lymphoblastic leukemia (ALL). With its targeted mechanism of action, favorable safety profile, and ability to induce deep molecular remissions, blinatumomab is increasingly incorporated into frontline treatment regimens for B-ALL. Recently, the Food and Drug Administration (FDA) has approved its use in the frontline setting for Ph-negative ALL. In Ph-negative ALL, combining blinatumomab with intensive chemotherapy has resulted in superior measurable residual disease (MRD) clearance and improved long-term outcomes. In Ph-positive ALL, combination therapies involving tyrosine kinase inhibitors (TKIs), particularly ponatinib and blinatumomab, are challenging the traditional approach of allogeneic hematopoietic stem cell transplantation (allo-SCT). This review explores the current evidence supporting the frontline use of blinatumomab in newly diagnosed adults with B-ALL, its impact on treatment paradigms, and potential future directions, including novel combination therapies and the role of emerging immunotherapeutic approaches.<\/jats:p>","DOI":"10.3390\/jcm14062055","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T04:34:43Z","timestamp":1742272483000},"page":"2055","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Integrating Blinatumomab in the Frontline Treatment in B-Cell Acute Lymphoblastic Leukemia: A New Era in Therapeutic Management"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4703-6280","authenticated-orcid":false,"given":"Martina","family":"Canichella","sequence":"first","affiliation":[{"name":"Hematology, St. Eugenio Hospital, ASL Roma2, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9280-2023","authenticated-orcid":false,"given":"Laura","family":"De Fazio","sequence":"additional","affiliation":[{"name":"Department of Hematology-Oncology, Azienda Universitaria Ospedaliera Renato Dulbecco, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6391-4406","authenticated-orcid":false,"given":"Matteo","family":"Molica","sequence":"additional","affiliation":[{"name":"Department of Hematology-Oncology, Azienda Universitaria Ospedaliera Renato Dulbecco, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1182\/blood.2023020794","article-title":"Diagnosis, prognostic factors, and assessment of ALL in adults: 2024 ELN recommendations from a European expert panel","volume":"143","author":"Boissel","year":"2024","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1182\/blood.2023023568","article-title":"Management of ALL in adults: 2024 ELN recommendations from a European expert panel","volume":"143","author":"Boissel","year":"2024","journal-title":"Blood"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1182\/blood-2018-10-881961","article-title":"A pediatric regimen for older adolescents and young adults with acute lymphoblastic leukemia: Results of CALGB 10403","volume":"133","author":"Stock","year":"2019","journal-title":"Blood"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1200\/JCO.2000.18.3.547","article-title":"Results of treatment with hyper-CVAD, a dose-intensive regimen, in adult acute lymphocytic leukemia","volume":"18","author":"Kantarjian","year":"2000","journal-title":"J. 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