CAR T-cell therapy in relapsed B-cell acute lymphoblastic leukemia (B-ALL) can result in high complete response rates; however, relapse can occur frequently in the following 12 months due to CD19-positive and negative relapses. From the American Society of Hematology (ASH) 2018 Annual Meeting and Exposition in San Diego, CA, Shannon Maude, MD, of the Children’s Hospital of Philadelphia, Philadelphia, PA, presents the results of a single instution experience of the use of PD-1 inhibitors in young (4-17 years old) B-ALL patients treated with CD19-directed CAR T-cell therapy, with the hypothesis that inhibiting PD-1 may decrease T-cell exhaustion, improving the function and persistence of the CAR T-cell therapy. Promising results were observed in those with early B-cell recovery and bulky extramedullary disease, but only partial, undurable effects were seen in the patients with poor initial marrow response to the CAR T-cell therapy.