CAR-T Meeting 2026 | The impact of prior transplantation on the durability and efficacy of tisa-cel in pediatric ALL
Rakefet Sidlik Muskatel, MD, PhD, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel, discusses the impact of prior allogeneic stem cell transplantation (alloSCT) on the durability and efficacy of tisagenlecleucel (tisa-cel) treatment in pediatric patients with acute lymphoblastic leukemia (ALL). She highlights that in a small cohort of patients, longer CAR T-cell persistence was observed in those who underwent alloSCT before tisa-cel therapy and suggests two possible explanations for these findings. This interview took place at the EBMT-EHA 8th European CAR T-cell Meeting, held in Palma de Mallorca, Spain.
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Transcript
So in our cohort, which was a small cohort, but then the results were pretty clear, we saw that there is a longer persistence of CAR-T in pediatric patients that received hematopoietic stem cell transplant prior to the CAR-T therapy. We still do not have a clear explanation of these results. We definitely need to look into it. I think of two possible explanations. One is the fact that these children were actually harvested after the transplant and therefore the cells are naive to chemotherapy...
So in our cohort, which was a small cohort, but then the results were pretty clear, we saw that there is a longer persistence of CAR-T in pediatric patients that received hematopoietic stem cell transplant prior to the CAR-T therapy. We still do not have a clear explanation of these results. We definitely need to look into it. I think of two possible explanations. One is the fact that these children were actually harvested after the transplant and therefore the cells are naive to chemotherapy. That might improve the fitness and then improve the product. And then another explanation is maybe something in the immune context that has changed after the transplant probably contributes to the persistence of the CAR-T and the durability of it. As for the implications, it’s really too early to say since actually we didn’t choose to give the CAR-T prior to or to give the hematopoietic stem cell transplant. It was decided by the clinical setting. And therefore, after we investigate a little bit further into the mechanism, then it might have a clinical implication. Although, you know, some patients receive CAR-T therapy without transplant and kept the durability. I believe it depends on the results we will find once we go into it.
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