Citations

Brexucabtagene-autoleucel (brexu-cel) produces high rates of measurable residual disease-negative (MRD-) complete response (CR) in adults with Philadelphia-chromosome positive (Ph+) acute lymphoblastic leukemia (ALL); however, subsequent relapses remain frequent. It is unclear whether maintenance with tyrosine kinase inhibitors (TKIs) can enhance remission durability. We evaluated outcomes among adults with relapsed/refractory Ph+ ALL who received commercial brexu-cel and achieved MRD- CR across 19 U.S. institutions. Considering TKI maintenance as a time-varying covariate, we analyzed outcomes based on receipt of subsequent TKI maintenance versus no maintenance. Patients receiving consolidative transplantation or non-TKI maintenance were excluded. Fifty-one patients were included: 20 received TKI maintenance and 31 received no maintenance. The use of TKI maintenance was associated with a significantly lower 1-year cumulative incidence of relapse (HR 0.12; 95% CI, 0.02-0.88; p=0.037) which translated into improved progression-free survival (PFS, HR 0.19; 95% CI, 0.04-0.85; p=0.029) and a trend towards improved overall survival (OS, HR 0.34; 95% CI, 0.07-1.62; p=0.18). There was no difference in non-relapse mortality (NRM, HR 0.83; 95% CI, 0.12-5.87; p=0.85). This real-world analysis supports the administration of TKI maintenance in Ph+ ALL following achievement of MRD- CR with brexu-cel as a strategy to improve PFS following chimeric antigen receptor T cell therapy.

Up to 30% of ischemic stroke cases are due to large vessel occlusion (LVO), causing significant morbidity. Studies have shown that the collateral circulation of patients with acute ischemic stroke (AIS) secondary to LVO can predict their clinical and radiological outcomes. The aim of this study is to identify baseline patient characteristics that can help predict the collateral status of these patients for improved triage. In this IRB approved retrospective study, consecutive patients presenting with AIS secondary to anterior circulation LVO were identified between September 2019 and August 2021. The baseline patient characteristics, laboratory values, imaging features and outcomes were collected using a manual chart review. From the 181 consecutive patients initially reviewed, 54 were confirmed with a clinical diagnosis of AIS and anterior circulation LVO. In patients with poor collateral status, the body mass index (BMI) was found to be significantly lower compared to those with good collateral status (26.4 ± 5.6 vs. 31.7 ± 12.3; p = 0.045). BMI of >35 kg/m2 was found to predict the presence of good collateral status. Age was found to be significantly higher (70.5 ± 9.6 vs. 58.9 ± 15.6; p = 0.034) in patients with poor collateral status and M1 strokes associated with older age and BMI.