{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"HemeTalks: Conversations in Hematology Education","title":"Blasting Through B-ALL: Modern Management from Induction to CAR T","html":"","width":"100%","height":180,"duration":1814,"description":"In this episode of HemeTalks, we dive into the evolving landscape of B-cell acute lymphoblastic leukemia (B-ALL) management with Dr. Adam DuVall. We begin with newly diagnosed disease, discussing which patients qualify for asparaginase containing pediatric inspired induction regimens. We then shift to the relapsed/refractory setting, exploring the roles of blinatumomab and inotuzumab ozogamicin as off-the-shelf therapies. Finally, we take a deep dive into CAR T cell therapy — comparing the three approved products, their costimulatory domains, toxicity profiles, and the growing evidence supporting CAR T as a destination therapy for a meaningful subset of patients. This episode offers practical, up-to-date guidance for clinicians caring for patients with B-ALL at every stage of disease.\n\nClinical Pearls:\n\n1. Asparaginase containing regimens are preferred induction for AYA patients with newly diagnosed B-ALL and early referral is critical. Applying pediatric-inspired protocols to patients aged from 18 to 50’s has meaningfully improved outcomes in this population. Referral to centers with experience using these regimens is important to optimize patient outcomes.  \n\n2. In relapsed/refractory B-ALL, blinatumomab and inotuzumab ozogamicin are important off the shelf options — but with distinct roles. Blinatumomab, a CD3-CD19 bispecific antibody, can achieve durable remissions in a subset of patients even without allogeneic transplant, but that patient population is yet to be determined. Inotuzumab ozogamicin, an anti-CD22 antibody-drug conjugate, is an effective bridge to transplant or CAR T but is not considered curative on its own. \n\n3. CAR T cell therapy is a legitimate destination therapy for a meaningful subset of B-ALL patients. Approximately 40-60% of patients may be cured with CAR T alone, making it an important option for those without a suitable donor or who cannot proceed to allogeneic transplant. The three approved products differ in costimulatory domain and...","thumbnail_url":"https://img.transistorcdn.com/ybjl9FP0yIIoAR9OW4-QMCeW4qWmBKc92wL1zHiuRRM/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9mYzM1/NDgwODVmNTJhYTU0/M2VjOGNiMjVlNzlk/NWI3MS5qcGc.webp","thumbnail_width":300,"thumbnail_height":300}