ASCO 2026 | The safety & efficacy of cladribine/cyclophosphamide lymphodepletion in CD19 CAR-T therapy for B-ALL
In this video, Kriti Gera, MD, Moffitt Cancer Center, Tampa, FL, discusses the safety and efficacy of cladribine/cyclophosphamide lymphodepletion in CD19 CAR T-cell therapy for B-cell acute lymphoblastic leukemia (B-ALL). Dr Gera highlights that her center observed superior safety outcomes with this regimen compared with fludarabine/cyclophosphamide, including a reduced risk of late infections and cytopenias. Additionally, efficacy outcomes remained comparable between the two regimens. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
Yes, so our center was using cladribine-cyclophosphamide during the fludarabine international shortage. And clinically, we started seeing better outcomes in terms of infections. And then in B-cell ALL patients, I analyzed the data. And in terms of the infections, the late infection risk is higher with the Flu-Cy versus the Clad-Cy regimen. And even the grade three or more thrombocytopenia and neutropenia are significantly higher in the Flu-Cy...
Yes, so our center was using cladribine-cyclophosphamide during the fludarabine international shortage. And clinically, we started seeing better outcomes in terms of infections. And then in B-cell ALL patients, I analyzed the data. And in terms of the infections, the late infection risk is higher with the Flu-Cy versus the Clad-Cy regimen. And even the grade three or more thrombocytopenia and neutropenia are significantly higher in the Flu-Cy. When adjusted for the HEMATOTOX score, the data showed that there was still a trend towards Flu-Cy having a higher risk for late infections and cytopenias. In terms of the efficacy, I looked at different outcomes such as overall survival, EFS and MRD negativity at day 30 and day 90 and there was no difference between the two. Also looked at grade 3 or more CRS and ICANS and there was no significant difference between the two groups.
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