David Marks, MB, MS, FRACP, PhD, FRCPath, University Hospitals Bristol NHS Foundation Trust, Bristol, UK, discusses the challenges of treating patients with acute lymphoblastic leukemia (ALL) with immunotherapy, including the toxicity associated with inotuzumab ozogamicin, the neurotoxicity and logistic challenges of blinatumomab, and the specialist set-up required to deliver CAR T-cell therapy. This interview took place during the 62nd American Society of Hematology (ASH) Annual Meeting and Exposition, 2020.