Subcutaneous Blinatumomab for CD19-Positive MPAL

This study is testing a drug called blinatumomab, given as a shot under the skin, for adults with CD19-positive Mixed Phenotype Acute Leukemia (MPAL). This type of leukemia has features of both lymphoid and myeloid cells. The study is looking at how well blinatumomab works in different groups of patients: those newly diagnosed who can't have strong chemotherapy, and those who have already had treatment but still have some leukemia cells (minimal residual disease). Success will be measured by how many patients achieve complete remission, meaning no signs of leukemia, and how long they live. The study plans to enroll 78 participants, but its current status is unclear.

Study design
This is a Phase 2, multicenter study that is not randomized and is open-label, meaning everyone knows what treatment is being given. It plans to enroll 78 adult participants.
What's involved
Not specified in the trial record.
Compensation
Not stated in the trial record.
Follow-up
For some participants, overall survival will be measured for up to 3 years after treatment.

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NCT07222579

Subcutaneous Blinatumomab for Treatment of Adult Patients With CD19-Positive Mixed Phenotype Acute Leukemia (MPAL)

Recruiting
PHASE2Ages 18+InterventionalTreatment
West Virginia University
~78 participants
Updated 2026-04-13 on ClinicalTrials.gov
What's tested:Subcutaneous Blinatumomab

At a glance

Recruiting sites
1 of 1 listed site is recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Cohort A - Overall Survival
Measured over Up to 3 years
+2 more outcomes measured
CD19 Positive
Mixed Phenotype Acute Leukemia (MPAL)
1 sites across 1 states
West Virginia1
  • Ashkan Emadi, MD · PRINCIPAL_INVESTIGATOR · WVU Cancer Institute

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Eligibility criteria

Inclusion

General Criteria for all three Cohorts
Subjects must have histologically or cytologically confirmed MPAL based on 2022 WHO criteria
Subjects who have undergone allo-HSCT are eligible if they are ≥ 4 weeks post stem cell infusion, have no evidence of GVHD \> Grade 2, and are at least ≥ 1 week off of immunosuppressive therapy. Per FDA recommendation, patients should be off of calcineurin inhibitors (CNIs) for at least 4 weeks before receiving blinatumomab
Subjects with a CNS leukemia must be clinically stable (i.e., asymptomatic with no focal neurological signs and symptoms, or signs and symptoms unchanged over 4 weeks with no \> grade 2 manifestations) with a flow cytometric clear CSF in the 2 weeks prior to day 1 of SC-blinatumomab administration.
Ability to understand and willingness to sign a written informed consent document
Agree to comply with the study requirements and agree to come to the clinic/hospital for required study visits
Subjects with hematologic malignancies are expected to have hematologic abnormalities at study entry
Specific Criteria for Cohort A
Specific Criteria for Cohort B
CD19+ MPAL in CR/CRh/CRi after at least one line of treatment with MRD positivity at a level of ≥0.1% using an assay with a minimum sensitivity of 0.01%.
ECOG performance status ≤2
Subjects must have organ function as below:
Direct bilirubin ≤ 2.5 mg/dL
AST/ALT/Alkaline phosphatase ≤ 5 X institutional upper limit of normal
Serum creatinine ≤ 3 mg/dL
Specific Criteria for Cohort C
Confirmed R/R CD19+ MPAL
Previous cytotoxic chemotherapy (except for hydroxyurea) must have been completed by 5 half-lives of the drug(s) prior to day 1 of SC-blinatumomab. Per FDA recommendation, patients should have recovered to no more than Grade 1 toxicities from prior chemotherapy.
ECOG performance status ≤2
Subjects must have organ function as below:
Direct bilirubin ≤ 2.5 mg/dL
AST/ALT/Alkaline phosphatase ≤ 5 X institutional upper limit of normal
Serum creatinine ≤ 3 mg/dL

Exclusion

Criteria for all three Cohorts
Subjects receiving any other investigational agents, or concurrent chemotherapy, radiation therapy, or immunotherapy for cancer treatment not including corticosteroids or hydroxyurea
Active, uncontrolled infection; subjects with infection under active treatment and controlled with antimicrobials are eligible
  • Cohort A - Overall SurvivalUp to 3 years

    The Overall Survival (OS) is the time from treatment initiation to death from any cause.

  • Cohort B - Rate of Complete Remission (CR), Complete Remission with Partial Hematological Recovery (CRh), or Complete Remission with Incomplete Hematological Recovery (CRi) with Minimal Residual Disease (MRD) negativityAt completion of 2 cycles (each cycle is 34 days)

    The rate of achievement of complete remission (CR/CRh/CRi) with MRD-negativity (\<0.01%) after the first two cycles of therapy with blinatumomab. CR: Bone marrow blasts \<5%; absence of circulating blasts; absence of extramedullary disease; absolute neutrophil count (ANC) ≥1000/µL and platelets ≥100,000/µL; MRD+ or unknown. CR +CRh: Bone marrow blasts \<5%; absence of circulating blasts; absence of extramedullary disease; ANC ≥500/µL AND platelet count ≥50,000/µL. CR +CRi: Bone marrow blasts \<5%; absence of circulating blasts; absence of extramedullary disease; with residual thrombocytopenia (platelet count of \<100,000/µL) OR residual neutropenia (ANC \<1000/µL); not fulfilling criteria for CRh. MRD Negativity: No detectable cancer cells using sensitive tests, with less than 0.01% cancer cells. MRD positivity indicates a higher risk of relapse, while MRD negativity is linked to long-term remission and survival benefits.

  • Cohort C - Rate of Complete Remission (CR) or Complete Remission with Partial Hematological Recovery (CRh)At completion of 2 cycles (each cycle is 34 days)

    The rate of achievement of complete remission (CR/CRh) after the first two cycles of therapy with blinatumomab. Complete Remission (CR): No detectable cancer cells in the bone marrow (less than 5% blast cells) and normal blood counts. CRh: No detectable cancer cells, with partial recovery of blood counts (ANC 500-1,000/µL, platelets 50,000-100,000/µL). The rate of achieving these states is calculated by the proportion of patients who reach CR/CRh within a set time. Higher rates of achievement indicate that a larger proportion of participants are responding positively to the treatment, with no detectable cancer cells in their bone marrow and recovery of blood counts.