Immunotherapy for acute leukemia: An updated SITC clinical practice guideline

An updated Society for Immunotherapy of Cancer (SITC) clinical practice guideline (version 2.0) on immunotherapy for the treatment of acute leukemia was published in Journal for ImmunoTherapy of Cancer by Shah et al. The guideline was developed by a multidisciplinary expert panel and includes evidence-based and consensus-based recommendations across diagnostic assessment, immunotherapy selection and treatment sequencing, response monitoring, toxicity management, and patient education and quality-of-life support.

Key data: Recommendations include blinatumomab for relapsed/refractory (R/R) CD19+ B-cell acute lymphoblastic leukemia (B-ALL), and for most patients with newly diagnosed CD19+ B-ALL as part of consolidation therapy, regardless of induction measurable residual disease (MRD) response. For newly diagnosed or R/R Philadelphia chromosome-positive (Ph+) B-ALL, blinatumomab plus tyrosine kinase inhibitors (TKIs) may be considered. Inotuzumab ozogamicin (InO) is recommended for R/R CD22+ B-ALL and may be considered in the first-line setting for older adults with B-ALL. Chimeric antigen receptor (CAR) T-cell therapy should be considered for R/R B-ALL, with early referral, followed by long-term surveillance for cytopenias, infection, and secondary malignancy. Achieving MRD negativity prior to allogeneic hematopoietic stem cell transplantation (allo-HSCT) is recommended for patients with ALL who have a transplant indication.

Key learning: This updated guideline provides a comprehensive framework to support hematologists and oncologists in treating ALL, highlighting immunotherapy agents and indications, response monitoring, and toxicity management.