mini-hyper-CVD + inotuzumab ozogamicin + blinatumomab

**Mini-hyper-CVD + inotuzumab ozogamicin + blinatumomab** is a sequential low-intensity combination regimen for relapsed/refractory B-cell acute lymphoblastic leukemia (ALL) in adults. It consists of mini-hyper-CVD chemotherapy (reduced doses of cyclophosphamide 150 mg/m² IV q12h days 1-3, vincristine 2 mg flat days 1/8, dexamethasone 20 mg days 1-4/11-14, methotrexate 75% reduced, cytarabine 0.5 g/m² x4, no anthracycline in odd cycles; alternating with cytarabine/methotrexate in even cycles), combined with fractionated inotuzumab ozogamicin (anti-CD22 antibody-drug conjugate, cumulative ~2.7 mg/m² over 4 cycles, e.g., 0.6 mg/m² day 2 + 0.3 mg/m² day 8 cycle 1, then 0.3 mg/m² days 2/8 cycles 2-4) for cycles 1-4, followed by blinatumomab (bispecific T-cell engager) for cycles 5-8, then POMP maintenance (prednisone, vincristine, 6-mercaptopurine, methotrexate) x12 with interspersed blinatumomab. Developed at MD Anderson Cancer Center, it achieves high response rates (~83% CR/CRi), deep MRD negativity, and improved survival vs historical controls, though with risks of veno-occlusive disease (VOD/SOS), mitigated by fractionation and sequencing. Primarily indicated for R/R ALL, including salvage 1-3+ and post-SCT relapse.[1][2][3]

Other names

mini-HCVD + inotuzumab ozogamicin + blinatumomabmini-hyper-CVD + fractionated inotuzumab ozogamicin + blinatumomab