Disease characteristics of patients developing B-ALL/BALLLP after lenalidomide treatment for MM
| ID# . | Sex . | Length of Len exposure (mo) . | Time from MM to ALL/BALLLP dx, y . | Age at ALL/BALLLP dx, y . | B-ALL induction . | B-ALL after induction (pre-HCT if HCT) . | Best response (pre-HCT if HCT) . | HCT donor (if HCT) . | B-ALL relapse? . | F/U from B-ALL diagnosis (mo) . | Last clinical status . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 01 | F | 53 | 5.4 | 66 | MSK L-2014 | MSK L-20 | MRD+ CR | MUD | N | 104.3 | Alive in CR after HCT |
| 02 | M | 57 | 5.6 | 66 | MSK L-20 | None | MRD− CR | Matched related donor | N | 98.0 | Alive in CR after HCT |
| 03 | M | 23 | 3.0 | 50 | MSK L-20 | MSK L-20 | CR | Matched related donor | N | 7.1 | Died in CR after HCT |
| 04 | F | 40 | 3.8 | 81 | MSK L-20 | POMP | NE | N/A | N | 27.1 | Developed therapy-related MDS and died subsequently; ALL was in CR |
| 05 | M | 69 | 7.7 | 64 | MSK 12-26615 | POMP | MRD− CR | MUD | N | 65.3 | Alive in CR after HCT |
| 06 | M | 68 | 6.1 | 63 | Hyper-CVAD | POMP, Hyper-CVAD | MRD− CR | MRD | Y | 35.8 | Relapsed after HCT and died with relapsed ALL |
| 07 | F | 61 | 7.6 | 68 | Augmented Hyper-CVAD | POMP, Blina | MRD− CR | N/A | N | 73.2 | Alive; ALL in CR though receiving therapy for MM |
| 08 | F | 69 | 5.9 | 52 | V + P | NE | NE | NE | N | 4.1 | Alive in CR as of last follow-up |
| 09∗ | M | 50 | 4.7 | 64 | Hyper-CVAD | Hyper-CVAD, Blina | MRD− CR | Haploidentical | N | 66.1 | Alive in CR after HCT |
| 10∗ | F | 6 | 0.6 | 75 | None; CR w/ holding Len | MRD− CR | N/A | N | 56.1 | Alive w/o B-ALL | |
| 11 | M | 39 | 5.0 | 60 | Hyper-CVAD | Hyper-CVAD | MRD+ CR | MMUD | N | 47.1 | Alive in CR after HCT |
| 12 | F | 54 | 5.3 | 53 | MSK 12-266 | MSK 12-266 | MRD− CR | N/A | N | 35.6 | Died with B-ALL in CR after subsequent HCT for therapy-related AML |
| 13 | F | 42 | 6.5 | 65 | Hyper-CVAD | Hyper-CVAD, Blina | MRD− CR | MUD | N | 12.3 | Died in CR after HCT |
| 14 | M | 69 | 7.2 | 64 | Hyper-CVAD + R | Hyper-CVAD + R | MRD− CR | MUD | N | 49.2 | Alive w/ in CR after HCT |
| 15‡ | F | 5 | 0.6 | 64 | None; CR w/ holding Len | MRD− CR | Autologous (for MM) | N | 43.9 | Alive w/o B-ALL after autologous HCT for MM | |
| 16 | M | 120+† | 15.7+ | 72 | Hyper-CVAD + R | Blina | MRD− CR | N/A | N | 36.1 | Alive in CR |
| 17 | F | 34 | 5.5 | 66 | Hyper-CVAD | Blina, m-HCVD + I, liposomal V | No CR | N/A | Never in CR | 14.5 | Died with refractory ALL |
| 18 | F | 102 | 9.8 | 68 | m-HCVD + I | m-HCVD + I | MRD− CR | MUD | N | 23.6 | Alive in CR after HCT |
| 19 | M | 17 | 5.8 | 83 | None | N/A | N/A | N/A | N | 1.2 | Died with ALL; not treated |
| 20 | F | 53 | 10.3 | 86 | V + P | V | MRD+ CR | N/A | Y | 5.4 | Died after salvage (I) for relapsed ALL |
| 21 | F | 114 | 10.1 | 64 | m-HCVD + I | m-HCVD + I | MRD− CR | MUD | N | 9.9 | Alive in CR after HCT |
| 22 | M | 95 | 10.0 | 61 | MSK 12-266 | MSK 12-266 | MRD− CR | N/A | N | 7.9 | Alive in CR |
| 23 | M | 35 | 3.5 | 68 | Hyper-CVAD | Methotrexate | CR | N/A | Y | 14.8 | Died after relapse of ALL |
| 24 | F | 45 | 4.0 | 63 | Hyper-CVAD – V | V + P | MRD− CR | N/A | Y | 7.7 | Died after relapse of ALL |
| 25 | F | 39 | 4.3 | 65 | Hyper-CVAD | Hyper-CVAD | MRD− CR | MUD | N | 66.4 | Alive in CR after HCT |
| 26 | M | 37 | 5.2 | 68 | V + P | Blina | CR‡ | N/A | Y | 33.1 | Died with relapsed ALL |
| 27 | F | 32 | 3.3 | 67 | Hyper-CVAD | Hyper-CVAD | MRD-CR | N/A | Y | 30.6 | Died after relapse of ALL |
| 28 | M | 32 | 4.1 | 58 | Hyper-CVAD + R | POMP | MRD-CR | N/A | N | 35.4 | Alive in CR after HCT |
| 29 | F | 49 | 6.0 | 68 | Hyper-CVAD | Hyper-CVAD | MRD-CR | MUD | Y | 48.2 | Died with relapsed ALL |
| 30 | F | 23 | 8.0 | 65 | CALGB 1010216 | NE | NE | N/A | N | 0.5 | Died during induction therapy |
| 31 | M | 2 | 11.7 | 86 | None | N/A | N/A | N/A | N | 0.4 | Died with ALL; not treated |
| 32 | F | 7 | 2.6 | 54 | Dexamethasone + dasatinib | NE | NE | N/A | N | 1.0 | Died during induction therapy |
| ID# . | Sex . | Length of Len exposure (mo) . | Time from MM to ALL/BALLLP dx, y . | Age at ALL/BALLLP dx, y . | B-ALL induction . | B-ALL after induction (pre-HCT if HCT) . | Best response (pre-HCT if HCT) . | HCT donor (if HCT) . | B-ALL relapse? . | F/U from B-ALL diagnosis (mo) . | Last clinical status . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 01 | F | 53 | 5.4 | 66 | MSK L-2014 | MSK L-20 | MRD+ CR | MUD | N | 104.3 | Alive in CR after HCT |
| 02 | M | 57 | 5.6 | 66 | MSK L-20 | None | MRD− CR | Matched related donor | N | 98.0 | Alive in CR after HCT |
| 03 | M | 23 | 3.0 | 50 | MSK L-20 | MSK L-20 | CR | Matched related donor | N | 7.1 | Died in CR after HCT |
| 04 | F | 40 | 3.8 | 81 | MSK L-20 | POMP | NE | N/A | N | 27.1 | Developed therapy-related MDS and died subsequently; ALL was in CR |
| 05 | M | 69 | 7.7 | 64 | MSK 12-26615 | POMP | MRD− CR | MUD | N | 65.3 | Alive in CR after HCT |
| 06 | M | 68 | 6.1 | 63 | Hyper-CVAD | POMP, Hyper-CVAD | MRD− CR | MRD | Y | 35.8 | Relapsed after HCT and died with relapsed ALL |
| 07 | F | 61 | 7.6 | 68 | Augmented Hyper-CVAD | POMP, Blina | MRD− CR | N/A | N | 73.2 | Alive; ALL in CR though receiving therapy for MM |
| 08 | F | 69 | 5.9 | 52 | V + P | NE | NE | NE | N | 4.1 | Alive in CR as of last follow-up |
| 09∗ | M | 50 | 4.7 | 64 | Hyper-CVAD | Hyper-CVAD, Blina | MRD− CR | Haploidentical | N | 66.1 | Alive in CR after HCT |
| 10∗ | F | 6 | 0.6 | 75 | None; CR w/ holding Len | MRD− CR | N/A | N | 56.1 | Alive w/o B-ALL | |
| 11 | M | 39 | 5.0 | 60 | Hyper-CVAD | Hyper-CVAD | MRD+ CR | MMUD | N | 47.1 | Alive in CR after HCT |
| 12 | F | 54 | 5.3 | 53 | MSK 12-266 | MSK 12-266 | MRD− CR | N/A | N | 35.6 | Died with B-ALL in CR after subsequent HCT for therapy-related AML |
| 13 | F | 42 | 6.5 | 65 | Hyper-CVAD | Hyper-CVAD, Blina | MRD− CR | MUD | N | 12.3 | Died in CR after HCT |
| 14 | M | 69 | 7.2 | 64 | Hyper-CVAD + R | Hyper-CVAD + R | MRD− CR | MUD | N | 49.2 | Alive w/ in CR after HCT |
| 15‡ | F | 5 | 0.6 | 64 | None; CR w/ holding Len | MRD− CR | Autologous (for MM) | N | 43.9 | Alive w/o B-ALL after autologous HCT for MM | |
| 16 | M | 120+† | 15.7+ | 72 | Hyper-CVAD + R | Blina | MRD− CR | N/A | N | 36.1 | Alive in CR |
| 17 | F | 34 | 5.5 | 66 | Hyper-CVAD | Blina, m-HCVD + I, liposomal V | No CR | N/A | Never in CR | 14.5 | Died with refractory ALL |
| 18 | F | 102 | 9.8 | 68 | m-HCVD + I | m-HCVD + I | MRD− CR | MUD | N | 23.6 | Alive in CR after HCT |
| 19 | M | 17 | 5.8 | 83 | None | N/A | N/A | N/A | N | 1.2 | Died with ALL; not treated |
| 20 | F | 53 | 10.3 | 86 | V + P | V | MRD+ CR | N/A | Y | 5.4 | Died after salvage (I) for relapsed ALL |
| 21 | F | 114 | 10.1 | 64 | m-HCVD + I | m-HCVD + I | MRD− CR | MUD | N | 9.9 | Alive in CR after HCT |
| 22 | M | 95 | 10.0 | 61 | MSK 12-266 | MSK 12-266 | MRD− CR | N/A | N | 7.9 | Alive in CR |
| 23 | M | 35 | 3.5 | 68 | Hyper-CVAD | Methotrexate | CR | N/A | Y | 14.8 | Died after relapse of ALL |
| 24 | F | 45 | 4.0 | 63 | Hyper-CVAD – V | V + P | MRD− CR | N/A | Y | 7.7 | Died after relapse of ALL |
| 25 | F | 39 | 4.3 | 65 | Hyper-CVAD | Hyper-CVAD | MRD− CR | MUD | N | 66.4 | Alive in CR after HCT |
| 26 | M | 37 | 5.2 | 68 | V + P | Blina | CR‡ | N/A | Y | 33.1 | Died with relapsed ALL |
| 27 | F | 32 | 3.3 | 67 | Hyper-CVAD | Hyper-CVAD | MRD-CR | N/A | Y | 30.6 | Died after relapse of ALL |
| 28 | M | 32 | 4.1 | 58 | Hyper-CVAD + R | POMP | MRD-CR | N/A | N | 35.4 | Alive in CR after HCT |
| 29 | F | 49 | 6.0 | 68 | Hyper-CVAD | Hyper-CVAD | MRD-CR | MUD | Y | 48.2 | Died with relapsed ALL |
| 30 | F | 23 | 8.0 | 65 | CALGB 1010216 | NE | NE | N/A | N | 0.5 | Died during induction therapy |
| 31 | M | 2 | 11.7 | 86 | None | N/A | N/A | N/A | N | 0.4 | Died with ALL; not treated |
| 32 | F | 7 | 2.6 | 54 | Dexamethasone + dasatinib | NE | NE | N/A | N | 1.0 | Died during induction therapy |
Blina, blinatumomab; CALGB 10102, off-protocol per published regimen, but without alemtuzumab; dx, diagnosis; F/U=follow-up; I, inotuzmab ozogamicin; Len, lenalidomide; MMUD, 1-locus mismatched unrelated donor; MUD, matched unrelated donor; N, no; N/A, not applicable; NE, not evaluable; P, corticosteroids; POMP, prednisone, vincristine, methotrexate, and mercaptopurine; R, rituximab; V, vincristine; Y, yes.
B-ALLLP by flow cytometry (not overt B-ALL) at diagnosis.
Exact date of lenalidomide start unclear but >120 months exposure.
CR achieved following blinatumomab.