{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T02:13:13Z","timestamp":1787883193860,"version":"build-2784847793"},"reference-count":5,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T00:00:00Z","timestamp":1692576000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Relapsed or refractory (r\/r) Philadelphia chromosome\u2013positive (Ph+) acute lymphoblastic leukemia (ALL) still represent an unmet clinical need despite the new immune therapies available for these patients. We report the case of a Ph\u2009+\u2009ALL relapsed one year after allogeneic stem cell transplant. After one DLI was started CAR\u2010T program with brexucabtageneautoleucel, using as bridging treatment ponatinib, vincristine and prednisone. Brexu\u2010cel infusion was performed in 2023, without CRS or ICANS onset. One month after Brexu\u2010cel infusion BM aspirate and CT\u2010PET showed recovery of full donor chimerism, MRD negativity and complete metabolic remission. Subsequently was started maintenance with ponatinib: at last follow\u2010up, the patient persisted in leukemia\u2010free status. CAR\u2010T cells represent the most powerful treatment for r\/r Ph\u2009+\u2009ALL but there is no consensus about the optimal bridging strategy and also regarding the management algorithm during \u201cpost CAR\u2010T phase\u201d. Here, we report the efficacy of ponatinib as a bridge to anti\u2010CD19 CAR\u2010T cell therapy and as post CAR\u2010T maintenance. Our experience suggests that a preserving approach with TKI associated to low\u2010dose chemotherapy can be the optimal bridging therapy prior to CAR\u2010T and that an \u201cMRD\u2010guided\u201d and \u201cTKI\u2010based\u201d maintenance strategy can represent the best choice for Ph\u2009+\u2009ALL which satisfactorily responds to CAR\u2010T.<\/jats:p>","DOI":"10.1111\/ejh.14087","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T07:22:47Z","timestamp":1692688967000},"page":"137-140","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Case Report: <scp>CAR\u2010T<\/scp> cells and subsequent maintenance with ponatinib in an adult Philadelphia acute lymphoblastic leukemia patient with hematological and extramedullary relapse after allogeneic stem cell transplantation"],"prefix":"10.1111","volume":"112","author":[{"given":"Filippo Antonio","family":"Canale","sequence":"first","affiliation":[{"name":"Stem Cell Transplantation and Cellular Therapies Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"},{"name":"Stem Cell Transplantation Program CIC 587 Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3982-4141","authenticated-orcid":false,"given":"Martina","family":"Pitea","sequence":"additional","affiliation":[{"name":"Stem Cell Transplantation and Cellular Therapies Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"},{"name":"Stem Cell Transplantation Program CIC 587 Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Alati","sequence":"additional","affiliation":[{"name":"Hematology Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetana","family":"Porto","sequence":"additional","affiliation":[{"name":"Stem Cell Transplantation and Cellular Therapies Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"},{"name":"Stem Cell Transplantation Program CIC 587 Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Pratico","sequence":"additional","affiliation":[{"name":"Hematology Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Utano","sequence":"additional","affiliation":[{"name":"Stem Cell Transplantation and Cellular Therapies Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"},{"name":"Stem Cell Transplantation Program CIC 587 Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessyca","family":"German\u00f2","sequence":"additional","affiliation":[{"name":"Hematology Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucrezia","family":"Imbalzano","sequence":"additional","affiliation":[{"name":"Stem Cell Transplantation and Cellular Therapies Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"},{"name":"Stem Cell Transplantation Program CIC 587 Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Ferreri","sequence":"additional","affiliation":[{"name":"Stem Cell Transplantation and Cellular Therapies Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"},{"name":"Stem Cell Transplantation Program CIC 587 Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Verduci","sequence":"additional","affiliation":[{"name":"Stem Cell Transplantation and Cellular Therapies Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"},{"name":"Stem Cell Transplantation Program CIC 587 Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovica","family":"Santoro","sequence":"additional","affiliation":[{"name":"Stem Cell Transplantation and Cellular Therapies Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"},{"name":"Stem Cell Transplantation Program CIC 587 Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Policastro","sequence":"additional","affiliation":[{"name":"Stem Cell Transplantation and Cellular Therapies Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"},{"name":"Stem Cell Transplantation Program CIC 587 Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Loteta","sequence":"additional","affiliation":[{"name":"Stem Cell Transplantation and Cellular Therapies Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"},{"name":"Stem Cell Transplantation Program CIC 587 Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Stem Cell Transplantation and Cellular Therapies Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"},{"name":"Stem Cell Transplantation Program CIC 587 Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Martino","sequence":"additional","affiliation":[{"name":"Stem Cell Transplantation and Cellular Therapies Unit Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"},{"name":"Stem Cell Transplantation Program CIC 587 Grande Ospedale Metropolitano, \u201cBianchi\u2010Melacrino\u2010Morelli\u201d  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-08-832105"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2020.260935"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(22)00319-2"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.33321"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01222-8"}],"container-title":["European Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.14087","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T21:52:34Z","timestamp":1704232354000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ejh.14087"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,21]]},"references-count":5,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1111\/ejh.14087"],"URL":"https:\/\/doi.org\/10.1111\/ejh.14087","archive":["Portico"],"relation":{},"ISSN":["0902-4441","1600-0609"],"issn-type":[{"value":"0902-4441","type":"print"},{"value":"1600-0609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,21]]},"assertion":[{"value":"2023-06-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}