EBMT 2021 | CAR-T therapy in adult ALL

Arnon Nagler, MD, MSc, Chaim Sheba Medical Center, Tel-Hashomer, Israel, discusses the latest developments in chimeric antigen receptor T-cell (CAR-T) therapy for adult patients with acute lymphoblastic leukemia (ALL). The treatment of relapsed/refractory adult ALL presents an unmet medical need, with a 5-year overall survival rate of 7 to 8%. Prof. Nagler reports that CAR-T therapy targeting CD19 has demonstrated efficacy in ALL, with about 80% of patients achieving a response and 50 to 60% achieving a complete response. The majority of patients who achieved a complete response in this study also achieved measurable residual disease (MRD)-negativity. Prof. Nagler discusses whether allogeneic stem cell transplantation (allo-SCT) is necessary after CAR-T therapy, outlining challenges associated with CAR T-cell persistence. A large analysis reported that patients who received allo-SCT after CAR-T therapy had a lower relapse rate and improved survival. Prof. Nagler also outlines the role of prognostic factors in predicting response to CAR-T therapy and therapy-related toxicities such as cytokine release syndrome. This interview took place during the 47th Annual Meeting of the European Group for Blood and Marrow Transplantation (EBMT) 2021.