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In our study, blinotumomab therapy, which was used in patients with relapsed pre-B acute lymphoblastic leukemia, was used to prevent treatment delay in two patients who did not relapse but developed chemotherapy toxicity. The clinical importance of our study is to emphasize that the use of blinotumomab is appropriate in patients with chemotherapy toxicity and treatment delay, and it prevents both toxicity and relapse development in patients.