Blood tests to predict CAR T-cell toxicity and efficacy

In this issue of Blood Advances, Valtis et al 1 report the prognostic impact of the CAR HEMATOTOX score on outcomes after CD19-directed chimeric antigen receptor (CAR) T-cell therapy for adults with relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL).Among adults with B-ALL, around half prove refractory to intensive first-line therapy, or relapse afterwards.CD19-directed CAR T cells represent an important treatment advance in this setting, resulting in complete remission in the majority. 2However, most responders to CAR T cells for R/R B-ALL subsequently relapse, leaving clinicians and patients with the challenging question of whether successful CAR T-cell therapy should be consolidated with allogeneic stem cell transplant.