[Brexu-cel cell therapy and subsequent allogeneic hematopoietic stem cell transplantation in the treatment of late-relapse B-cell acute lymphoblastic leukemia].

Here we report the case of a 39 years old patient who experienced a hematological relapse of B-cell acute lymphoblastic leukemia 23 months after completion of maintenance therapy. Relapse occurred two days after brexu-cel approval for reimbursement within the Italian National Health System. This favourable timing enabled the prompt apheresis for brexu-cel manufacturing, bridge therapy with inotuzumab ozogamicin and subsequently brexu-cel infusion. The patient achieved a complete molecular remission and thereafter performed an allogeneic stem cell transplantation. Currently, at 19 and 15 months after brexu-cel infusion and transplant, respectively, the patient presents sustained MRD negative remission with no graft-versus-host-disease evidence and a good quality of life.