What regimen would you offer a young patient with T-cell ALL who recurred a short time after allo-transplant and was initially treated with CALGB10403?
Especially with the current drug shortage of nelarabine.
Answer from: Medical Oncologist at Academic Institution
The answer is always clinical trial if feasible. If only commercial options: Assuming morphologic relapse, I tend to favor peg-asp containing regimen if the patient is fit enough to receive – especially if ETP variant. I like SMILE, but important to stress that regimen may come with considerab...
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Answer from: Medical Oncologist at Academic Institution
This is a very challenging situation. Historically, the anticipated outcome for anyone who relapses after allogeneic transplantation is quite poor (e.g., Gökbuget et al., PMID 22493293). The optimal treatment for a patient like this is not known, but ideally, it would be on a prospective clinic...