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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="other" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Pediatric Hematology/Oncology and Immunopathology</journal-id><journal-title-group><journal-title xml:lang="en">Pediatric Hematology/Oncology and Immunopathology</journal-title><trans-title-group xml:lang="ru"><trans-title>Вопросы гематологии/онкологии и иммунопатологии в педиатрии</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1726-1708</issn><issn publication-format="electronic">2414-9314</issn><publisher><publisher-name xml:lang="en">Fund Doctors, Innovations, Science for Children</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">695</article-id><article-id pub-id-type="doi">10.24287/1726-1708-2023-22-1-62-72</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="article-type"><subject></subject></subj-group></article-categories><title-group><article-title xml:lang="en">The role of blinatumomab in the treatment of B-cell relapses of acute lymphoblastic leukemia in children: own experience</article-title><trans-title-group xml:lang="ru"><trans-title>Роль блинатумомаба в лечении В-клеточных рецидивов острого лимфобластного лейкоза у детей: собственный опыт применения</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7959-3512</contrib-id><name-alternatives><name xml:lang="en"><surname>Vavilova</surname><given-names>L. A.</given-names></name><name xml:lang="ru"><surname>Вавилова</surname><given-names>Л. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p><bold> </bold><bold>Ludmila A. Vavilova</bold>, a pediatric oncologist at the Department of Oncohematology</p><p>1 Samory Mashela St., Moscow 117997, Russia </p></bio><bio xml:lang="ru"><p><bold>Вавилова Людмила Александровна</bold>, врач-детский онколог отделения онкогематологии </p><p>117997, Москва, ул. Саморы Машела, 1</p></bio><email>ludmila.vavilova@fccho-moscow.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8725-7532</contrib-id><name-alternatives><name xml:lang="en"><surname>Dyakonova</surname><given-names>Yu. Yu.</given-names></name><name xml:lang="ru"><surname>Дьяконова</surname><given-names>Ю. Ю.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Moscow</p></bio><bio xml:lang="ru"><p> Москва </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3232-2322</contrib-id><name-alternatives><name xml:lang="en"><surname>Bydanov</surname><given-names>O. I.</given-names></name><name xml:lang="ru"><surname>Быданов</surname><given-names>О. И.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Moscow</p></bio><bio xml:lang="ru"><p> Москва </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4779-1896</contrib-id><name-alternatives><name xml:lang="en"><surname>Myakova</surname><given-names>N. V.</given-names></name><name xml:lang="ru"><surname>Мякова</surname><given-names>Н. В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Moscow</p></bio><bio xml:lang="ru"><p> Москва </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5201-6475</contrib-id><name-alternatives><name xml:lang="en"><surname>Abugova</surname><given-names>Yu. G.</given-names></name><name xml:lang="ru"><surname>Абугова</surname><given-names>Ю. Г.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Moscow</p></bio><bio xml:lang="ru"><p> Москва </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3247-8688</contrib-id><name-alternatives><name xml:lang="en"><surname>Anderzhanova</surname><given-names>L. Kh.</given-names></name><name xml:lang="ru"><surname>Андержанова</surname><given-names>Л. Х.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Moscow</p></bio><bio xml:lang="ru"><p> Москва </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2801-7421</contrib-id><name-alternatives><name xml:lang="en"><surname>Evstratov</surname><given-names>D. A.</given-names></name><name xml:lang="ru"><surname>Евстратов</surname><given-names>Д. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Moscow</p></bio><bio xml:lang="ru"><p> Москва </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4767-5382</contrib-id><name-alternatives><name xml:lang="en"><surname>Kurnikova</surname><given-names>E. E.</given-names></name><name xml:lang="ru"><surname>Курникова</surname><given-names>Е. Е.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Moscow</p></bio><bio xml:lang="ru"><p> Москва </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0889-6986</contrib-id><name-alternatives><name xml:lang="en"><surname>Popov</surname><given-names>A. M.</given-names></name><name xml:lang="ru"><surname>Попов</surname><given-names>А. М.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Moscow</p></bio><bio xml:lang="ru"><p> Москва </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2352-7716</contrib-id><name-alternatives><name xml:lang="en"><surname>Olshanskaya</surname><given-names>Yu. V.</given-names></name><name xml:lang="ru"><surname>Ольшанская</surname><given-names>Ю. В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Moscow</p></bio><bio xml:lang="ru"><p> Москва </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1735-0093</contrib-id><name-alternatives><name xml:lang="en"><surname>Maschan</surname><given-names>M. A.</given-names></name><name xml:lang="ru"><surname>Масчан</surname><given-names>М. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Moscow</p></bio><bio xml:lang="ru"><p> Москва </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0520-5630</contrib-id><name-alternatives><name xml:lang="en"><surname>Shelikhova</surname><given-names>L. N.</given-names></name><name xml:lang="ru"><surname>Шелихова</surname><given-names>Л. Н.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Moscow</p></bio><bio xml:lang="ru"><p> Москва </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Litvinov</surname><given-names>D. V.</given-names></name><name xml:lang="ru"><surname>Литвинов</surname><given-names>Д. В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Moscow</p></bio><bio xml:lang="ru"><p> Москва </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5318-8033</contrib-id><name-alternatives><name xml:lang="en"><surname>Popa</surname><given-names>A. V.</given-names></name><name xml:lang="ru"><surname>Попа</surname><given-names>А. В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Moscow</p></bio><bio xml:lang="ru"><p> Москва </p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Karachunskiy</surname><given-names>A. I.</given-names></name><name xml:lang="ru"><surname>Карачунский</surname><given-names>А. И.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Moscow</p></bio><bio xml:lang="ru"><p> Москва </p></bio><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation</institution></aff><aff><institution xml:lang="ru">ФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава России</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2023-03-01" publication-format="electronic"><day>01</day><month>03</month><year>2023</year></pub-date><volume>22</volume><issue>1</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>62</fpage><lpage>72</lpage><history><date date-type="received" iso-8601-date="2023-01-31"><day>31</day><month>01</month><year>2023</year></date><date date-type="accepted" iso-8601-date="2023-02-27"><day>27</day><month>02</month><year>2023</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2023, «D. Rogachev NMRCPHOI»</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2023, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="en">«D. Rogachev NMRCPHOI»</copyright-holder><copyright-holder xml:lang="ru">ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://hemoncim.com/jour/article/view/695">https://hemoncim.com/jour/article/view/695</self-uri><abstract xml:lang="en"><p>Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. Despite remarkable improvements in the treatment of pediatric acute lymphoblastic leukemia over last years, relapse still carries a poor prognosis with considerable morbidity and mortality. New immunotherapeutic approaches will change the way we treated our patients and the results we had. Blinatumomab is a bispecific T-cell-engaging antibody indicated for the treatment of relapsed/refractory B-cell lymphoblastic leukemia. The use of Blinatumomab in relapsed B-cell ALL has shown promising effects, especially as a bridging tool to hematopoietic stem cell transplantation. The therapy results for patients in the high risk group remain far from optimal due to refractoriness to chemotherapy, death from infectious complications, as well as acute chemotherapy toxicity. This article demonstrates the results of our experience of using Blinatumomab in children with the high-risk group relapsed B-cell ALL treated according to the ALL-REZ 2016 protocol. The study was approved by the Independent Ethics Committee and the Scientific Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology. The efficacy and toxicity of innovational blocks with the use of fludarabine and clofarabine with subsequent Blinatumomab infusion are shown. And we present the efficacy of autologous CD3<sup>+</sup> lymphocytes infusion once a week during the continuous blinatumomab therapy. Also we demonstrate the results of using Blinatumomab for the treatment of patients with refractory to the first line therapy relapsed B-lymphoblastic leukemia and patients with a second relapse of B-cell ALL. The first line therapy in these patients was carried out according to the ALL-REZ 2014 protocol. Our results show an improved reduction in minimal residual disease in patients with refractory relapsed B-cell ALL as well as an increased event free survival in children with the high-risk group relapsed B-cell ALL.</p></abstract><trans-abstract xml:lang="ru"><p>Острый лимфобластный лейкоз (ОЛЛ) является самым распространенным онкологическим заболеванием у детей. Несмотря на значимые улучшения в терапии ОЛЛ за последние годы, лечение рецидивов остается проблемой, сохраняется плохой прогноз с высокой частотой развития рефрактерности к терапии и высокой смертностью. Новые иммунотерапевтические подходы к лечению ОЛЛ изменили результаты и прогноз таких пациентов. Блинатумомаб, представляющий собой биспецифическое антитело, селективно связывающееся с антигеном CD19, экспрессируемым на поверхности В-клеток, и антигеном CD3, экспрессируемым на поверхности Т-клеток, показал свою эффективность в терапии рецидивов В-клеточного ОЛЛ, особенно в качестве «мостика» для трансплантации гемопоэтических стволовых клеток. Результаты лечения пациентов группы высокого риска остаются далекими от оптимальных из-за рефрактерности к химиотерапии, ее высокой токсичности и летальных исходов от инфекционных осложнений. В данной статье представлены результаты нашего опыта применения блинатумомаба у детей с рецидивами В-клеточного ОЛЛ, получавших терапию в рамках группы высокого риска по протоколу ALL-REZ 2016. Исследование одобрено независимым этическим комитетом и утверждено решением ученого совета НМИЦ ДГОИ им. Дмитрия Рогачева. Продемонстрированы эффективность и токсичность блоков с применением флударабина и клофарабина с последующей инфузией блинатумомаба. Показана эффективность инфузии аутологичных CD3<sup>+</sup>-лимфоцитов 1 раз в неделю во время непрерывной терапии блинатумомабом. Также представлены результаты применения блинатумомаба для лечения пациентов с рефрактерным к терапии 1-й линии рецидивирующим В-клеточным ОЛЛ и пациентов со вторым рецидивом ОЛЛ. Терапия 1-й линии у этих пациентов проводилась по протоколу ALL-REZ 2014. Наши результаты показали снижение минимальной остаточной болезни у пациентов с рефрактерным рецидивирующим В-клеточным ОЛЛ, а также увеличение бессобытийной выживаемости у детей с рецидивирующим В-клеточным ОЛЛ группы высокого риска.</p></trans-abstract><kwd-group xml:lang="en"><kwd>acute lymphoblastic leukemia</kwd><kwd>relapse</kwd><kwd>children</kwd><kwd>treatment</kwd><kwd>blinatumomab</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>острый лимфобластный лейкоз</kwd><kwd>рецидив</kwd><kwd>дети</kwd><kwd>терапия</kwd><kwd>блинатумомаб</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><citation-alternatives><mixed-citation xml:lang="en">1. Sigmund A.M., Sahasrabudhe K.D., Bhatnagar B. Evaluating Blinatumomab for the Treatment of Relapsed/Refractory ALL: Design, Development, and Place in Therapy. 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