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

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

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Philadelphia (Ph)-like acute lymphoblastic leukemia (ALL) Hoodie and sweatpants set 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 Beckett 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.