How do you determine when to give a second CAR-T cell infusion to a pediatric or young adult patient with relapsed/refractory ALL?
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Stipulating clinical fitness/donor availability, do you refer/perform a consolidative allo-HSCT among patients who achieve MRD negative CR after CAR T cell therapy for relapsed/refractory ALL?
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2 Answers
Mednet MemberInvited Expert
Medical Oncology · The Ohio State University College of Medicine
Answered on
Anti-CD19 CAR-T cell therapy has the capacity to induce high rates of clinical response in heavily pre-treated patients for CD19 expressing B-cell malignancies. Among those, B-cell ALL is a poster child for CAR T cell therapy given the propensity for inducing high rates of MRD-negative complete resp...
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Mednet MemberInvited Expert
Hematology · Hospital of the University of Pennsylvania
Answered on
I would also add, in addition to @Dr. First Last's excellent response to this inquiry, that careful consideration should be given to the primary endpoint for considering a second CAR T-cell infusion.
If it is to allow for a subsequent remission followed by consolidation with an allogeneic stem cell ...
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