This protocol addresses a specific sub-population of adult B-lineage acute lymphoblastic leukemia (B-LIN ALL) defined by the expression of the CD20 antigen on more than 10% to 20% of leukemic blasts — a phenotypic feature that shapes the treatment approach.
B-lineage ALL with CD20 antigen expression on >10% to 20% of blasts. Approximately 40% of adult B-lineage ALL cases express CD20 at this threshold, identifying a distinct population for targeted treatment augmentation.
The standard chemotherapy backbone is augmented with the addition of an anti-CD20 antibody — administered concurrently across induction, consolidation, and maintenance phases. The complete regimen, sequencing, and full set of clinical considerations are available in the structured protocol.
DOI: 10.1182/blood.2023023568
Approximately 40% of adult B-lineage (B-LIN) ALL express the CD20 antigen in >10% to 20% ALL blasts.
Overall, the use of Ritux is recommended for the management of CD20+ ALL, for at least 8 doses.
The concurrent use of an anti-CD20 antibody in CD20+ ALL represents SoC as well as the use of Blina in case of molecular failure.
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