Blinatumomab after Donor Stem Cell Transplant in Treating Patients with Acute Lymphoblastic Leukemia

Inclusion Criteria

• Patients with B-lineage ALL in a) hematologic complete remission (CR) beyond CR1 at time of transplant; patients beyond CR1 or with primary induction failure may be without minimal residual disease, b) any residual disease defined by positive flow > 0.01%, detection of breakpoint cluster region-abelson murine leukemia viral oncogene homolog 1 (BCR-ABL) transcript by polymerase chain reaction (PCR) with a sensitivity of 1/10,000, or detection of the t(9;22) translocation in any metaphases by cytogenetics at time of transplant, or presence of the MLL gene
• Received an allogeneic HCT within the last 100 days; enrollment within 30-100 days after transplant, and after adequate recovery of counts
• Absolute neutrophil count (ANC) >= 0.5 x 10^9/L without daily use of myeloid growth factor
• Platelet > 20 x 10^9/L without platelet transfusion within 1 week
• Creatinine clearance greater than 30 ml/min (or greater than 60 ml/min/1.73)
• Alanine aminotransferase (ALT)/aspartate aminotransferase (AST) < 5 x upper limit of normal (ULN)
• Serum bilirubin < 3 x ULN
• Performance status of 0, 1, or 2; Karnofsky (or Lansky for subjects < 16 years old) performance status >= 50

Exclusion Criteria

• Relapsed ALL defined as > 5% malignant blasts in bone marrow or peripheral blood
• Active GVHD requiring systemic steroid therapy; medications for GVHD prophylaxis are acceptable
• Systemic steroid therapy unless for physiologic replacement
• Uncontrolled disease/infection as judged by the treating physician
• Active ALL in the central nervous system (CNS), as defined by >= 5 leukocytes per microL with identifiable blast cells in the cerebrospinal fluid (CSF), and/or the presence of cranial-nerve palsies
• Pregnant or nursing women