The Society for Immunotherapy of Cancer has published version 2.0 of its clinical practice guideline on immunotherapy for acute leukaemia. An expert panel developed evidence- and consensus-based recommendations on diagnostics, on immunotherapy for acute lymphoblastic leukaemia, acute myeloid leukaemia and blastic plasmacytoid dendritic cell neoplasm, and on toxicity management, treatment sequencing and patient education.
Immunotherapies covered include T-cell engagers such as blinatumomab, antibody-drug conjugates such as inotuzumab ozogamicin and gemtuzumab ozogamicin, and CAR-T cell therapy. These have changed outcomes, particularly in B-cell ALL, but have made sequencing decisions complex.
The abstract does not list specific recommendations; readers should consult the full guideline. In India, CAR-T therapy is now available through locally developed products, which makes sequencing guidance directly relevant here.
- Consult the updated SITC guideline for sequencing T-cell engagers, antibody-drug conjugates and CAR-T in acute leukaemia.
- As a general practice point, not quoted from the guideline, assess CD19, CD22 and CD33 expression when planning immunotherapy.
- As a general practice point, not quoted from the guideline, train teams to recognise cytokine release syndrome and neurotoxicity early.
- Locally developed CAR-T products in India make referral pathways worth knowing.
Why it matters
Front-line and relapse treatment for acute leukaemia now depends on choosing the right immunotherapy in the right order.
Don't overread it
Parts of the guideline are consensus-based rather than trial-based.
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