Michael R. Grunwald, MD, FACP, discusses disease progression in patients with low-risk myelofibrosis enrolled in the prospective MOST study.

Dr Grunwald on the Rates of Disease Progression in Low-Risk Myelofibrosis

Michael R. Grunwald, MD, FACP, hematologist/ oncologist, chief, Leukemia Division; director, Transplantation and Cellular Therapy Program, Levine Cancer Institute, Atrium Health, discusses the rates and incidence of disease progression in patients with low-risk myelofibrosis who were enrolled in the prospective Myelofibrosis and Essential Thrombocythemia Observational Study (MOST; NCT02953704).

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Dr Grunwald on the Rates of Disease Progression in Low-Risk Myelofibrosis  

Michael R. Grunwald, MD, FACP, a clinical assistant professor of medicine at the University of North Carolina, and a hematologist/ oncologist at the Levine Cancer Institute, Atrium Health, discusses the clinical implications of tisagenlecleucel (Kymriah) in the treatment of patients with B-cell acute lymphoblastic leukemia (B-ALL).

Having a CAR T-cell therapy available for the treatment of patients with B-ALL has being exciting, Grunwald says. However, the agent is currently only FDA approved for use in patients up to age 25 years whose disease is refractory or in second or later relapse, Grunwald notes.

Further studies of tisagenlecleucel, as well as similar agents, will be important for older patients with B-ALL because more options are needed in this population, Grunwald continues. For younger patients, however, having this agent available has been significant, as it can get them back into remission. Sometimes patients who receive the agent can experience a very durable remission following relapse, Grunwald concludes.

Michael R. Grunwald, MD, FACP, discusses the clinical implications of tisagenlecleucel in the treatment of patients with B-cell acute lymphoblastic leukemia.

Dr. Grunwald on the Clinical Implications of Tisagenlecleucel in B-ALL Treatment

Michael R. Grunwald, MD, FACP, a clinical assistant professor of medicine at the University of North Carolina, as well as a hematologist/oncologist at Levine Cancer Institute, Atrium Health, discusses the established and potential utility of tisagenlecleucel (Kymriah) in patients with acute lymphoblastic leukemia (ALL).

Having a CAR T-cell therapy available for patients with ALL has been exciting, according to Grunwald. However, the agent is only currently approved for use in younger patients with relapsed/refractory disease, and only those who are 25 years of age or younger can qualify for treatment. 

Further studies examining tisagenlecleucel and other agents in older patients with ALL will be important, as more options are needed for that population, Grunwald says. However, having tisagenlecleucel available for younger patients has been beneficial, as it has helped them achieve a durable remission following relapse, Grunwald concludes.

Michael R. Grunwald, MD, FACP, discusses the established and potential utility of tisagenlecleucel in patients with acute lymphoblastic leukemia.


Dr. Grunwald on the Established and Potential Utility of Tisagenlecleucel in ALL

Michael R. Grunwald, MD, FACP, a clinical assistant professor of medicine at the University of North Carolina, as well as a hematologist/oncologist at Levine Cancer Institute, Atrium Health, discusses preventing relapse in patients with lymphoid and myeloid malignancies following allogeneic transplantation.

Several ongoing efforts seek to prevent relapse in patients with myeloid and lymphoid malignancies, according to Grunwald. Many of these strategies incorporate targeted agents after transplantation. For example, in patients who have 

 mutations, or those with leukemia harboring a Philadelphia chromosome, a targeted inhibitor will be utilized following transplantation, Grunwald says.

However, a prospective study demonstrating an advantage for a targeted inhibitor after transplant has yet to be conducted. Currently, an ongoing study in patients with 

 mutations is examining the use of gilteritinib (Xospata) vs placebo after transplantation, the results of which are anticipated, Grunwald concludes.

Michael R. Grunwald, MD, FACP, discusses preventing relapse in patients with lymphoid and myeloid malignancies following allogeneic transplantation.

Dr. Grunwald on Preventing Relapse in Lymphoid and Myeloid Malignancies

Michael R. Grunwald, MD, FACP, clinical assistant professor of medicine, University of North Carolina, hematologist/oncologist, Levine Cancer Institute, Atrium Health, discusses the efficacy of 19-28z CAR T-cell therapy in B-cell acute lymphoblastic leukemia (B-ALL).

Long-term follow-up results of a phase 1 trial (NCT01044069) demonstrated a median overall survival of 12.9 months with 19-28z CAR T-cell therapy in adult patients with relapsed/refractory B-ALL, says Grunwald.

Overall, 53 patients with heavily pretreated disease received the 19-28z CAR T-cell therapy. Nineteen of these patients (36%) had undergone prior allogeneic hematopoietic stem cell transplant and 13 (25%) received prior blinatumomab (Blincyto), Grunwald explains. Patients were a median of 44 years old (range, 23-74), adds Grunwald.

Regarding efficacy, 83% of patients achieved a complete remission with 19-28z CAR T-cell therapy, says Grunwald. Some modifications were made during the study treatment with the goal of reducing CAR T-cell therapy–related toxicities, such as cytokine release syndrome, Grunwald says. Fractionating the doses of cells may reduce the rate of toxicity in adults; however, the promising efficacy signal suggests that this therapy should be evaluated further in patients with relapsed/refractory B-ALL, concludes Grunwald.

Michael R. Grunwald, MD, FACP, discusses the efficacy of 19-28z CAR T-cell therapy in B-cell acute lymphoblastic leukemia.   



Michael R. Grunwald, MD, FACP

Articles

Dr Grunwald on the Rates of Disease Progression in Low-Risk Myelofibrosis

Dr. Grunwald on the Clinical Implications of Tisagenlecleucel in B-ALL Treatment

Dr. Grunwald on the Established and Potential Utility of Tisagenlecleucel in ALL

Dr. Grunwald on Preventing Relapse in Lymphoid and Myeloid Malignancies

Dr. Grunwald on the Efficacy of 19-28z CAR T-Cell Therapy in B-ALL