Blinatumomab Administration in Pediatric B-Lineage ALL: Expert Recommendations From the Children’s Oncology Group

Abstract

BACKGROUND: The addition of blinatumomab to chemotherapy is the new standard of care for most pediatric patients with B-lineage acute lymphoblastic leukemia (B-ALL), and its use has increased rapidly. Administering blinatumomab to pediatric patients is associated with a spectrum of unique challenges, resulting in variable practices across institutions. OBJECTIVES: This article presents expert recommendations for blinatumomab administration in patients with pediatric B-ALL. METHODS: Pediatric oncology nurses, physicians, and pharmacists collated current evidence and Children’s Oncology Group institutional experiences to identify considerations for planning for blinatumomab administration, initiating and managing infusions, and monitoring for adverse events. FINDINGS: Engaging patients, families, and clinicians promotes care transitions between inpatient and outpatient settings and minimizes complications. Ongoing institutional commitment to monitor and capture emerging trends in blinatumomab administration can inform future optimal care practices.