Frontiers in Oncology (Jan 2023)

Case report: Ponatinib as a bridge to CAR-T cells and subsequent maintenance in a patient with relapsed/refractory Philadelphia-like acute lymphoblastic leukemia

  • Fabio Giglio,
  • Fabio Giglio,
  • Edoardo Campodonico,
  • Edoardo Campodonico,
  • Francesca Lorentino,
  • Francesca Lorentino,
  • Maddalena Noviello,
  • Elisabetta Xue,
  • Raffaella Greco,
  • Lorenzo Lazzari,
  • Alessandro Bruno,
  • Maria Teresa Lupo Stanghellini,
  • Matteo Giovanni Carrabba,
  • Roberta La Starza,
  • Monica Casucci,
  • Chiara Bonini,
  • Chiara Bonini,
  • Sabina Chiaretti,
  • Jacopo Peccatori,
  • Robin Foà,
  • Fabio Ciceri,
  • Fabio Ciceri

DOI
https://doi.org/10.3389/fonc.2022.1100105
Journal volume & issue
Vol. 12

Abstract

Read online

Philadelphia (Ph)-like acute lymphoblastic leukemia (ALL) constitutes a heterogeneous subset of ALL with a uniformly unfavorable prognosis. The identification of mutations amenable to treatment with tyrosine kinase-inhibitors (TKIs) represents a promising field of investigation. We report the case of a young patient affected by relapsed/refractory Ph-like ALL treated with chimeric antigen receptor T (CAR-T) cells after successful bridging with compassionate-use ponatinib and low-dose prednisone. We restarted low-dose ponatinib maintenance three months later. Twenty months later, measurable residual disease negativity and B-cell aplasia persist. To the best of our knowledge, this is the first case reporting the use of ponatinib in Ph-like ALL as a bridge to and maintenance after CAR-T cell therapy.

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