Highlights from EHA2026 – Update in ALL

Key findings in CAR T-cell therapy for ALL at the European Hematology Association (EHA) Congress 2026^1-4

CAR T-cell therapy continues to transform the treatment of acute lymphoblastic leukemia (ALL), particularly for people whose disease has come back after treatment (relapsed) or has not responded to previous therapies (refractory). CAR T-cells are made by collecting a patient’s own immune cells, called T cells, and modifying them in a laboratory so they can recognize and attack leukemia cells. Several studies presented at EHA 2026 highlighted promising approved and new investigational CAR T-cell therapies for both B-cell ALL (B-ALL) and T-cell ALL (T-ALL), as well as strategies to improve outcomes before and after treatment.

One study investigated a CAR T-cell therapy called NS7CAR, which targets a protein called CD7 found on the surface of T-ALL cells. The treatment was given to 171 people with relapsed or refractory T-ALL or lymphoma. In this study, 91% of people achieved remission, meaning no signs of leukemia cells could be detected in the blood or bone marrow using standard tests. 89% of patients had no detectable leukemia using highly sensitive testing known as measurable residual disease (MRD) testing. After more than two years of follow-up, 75% of patients were still alive. The study also found that people who went on to receive a bone marrow (stem cell) transplant after CAR T-cell therapy lived longer without leukemia coming back than those who did not, highlighting the continuing importance of transplantation. NS7CAR is still being investigated in clinical trials and has not yet received approval.

Another study focused on obecabtagene autoleucel (obe-cel), a CAR T-cell therapy that has been approved for people with relapsed or refractory B-ALL. Making CAR T-cells such as obe-cel involves several key steps and there can be a delay between collecting immune cells from a patient and receiving the CAR T therapy. Treatment known as bridging therapy may be given while the CAR T-cells are being made. This aims to stop the cancer from getting worse while waiting for the CAR T-cells to be ready. In the past, chemotherapy was often used for bridging therapy. This study explored whether giving new treatments such as targeted therapy and immunotherapy was more effective.

In this study found that patients who started obe-cel treatment with lower levels of leukemia (molecular remission) tended to do better. Newer targeted therapies and immunotherapies appeared to be more effective than traditional chemotherapy as bridging therapies to reduce the number of leukemia cells before CAR T treatment. These findings suggest that lowering the number of leukemia cells before CAR T-cell therapy may improve the chances of living longer without signs of leukemia.

Researchers also presented updated results from an early study of UCART22, a CAR T-cell therapy that targets a protein called CD22 found on many B-ALL cells. UCART22 is described as an ‘off-the-shelf’ CAR T-cell product as it is made from healthy donor cells rather than the patient’s own cells. This means that UCART22 does not need to be made specially for each person and can be available quicker. The side effects with this treatment were manageable in heavily pre-treated patients. At the most effective dose, 40% of patients achieved remission, and nearly 80% of those who responded had no detectable leukemia using MRD testing. Importantly, 53% of the patients who responded to treatment were able to proceed to a potentially curative bone marrow transplant. While UCART22 is not yet approved, these encouraging results have led to a larger phase II study that is now underway.

A fourth study compared two ways to get patients with relapsed or refractory B-ALL ready for a bone marrow transplant: CAR T-cell therapy or the immunotherapies, blinatumomab and inotuzumab ozogamicin. Both approaches helped many patients reduce their leukemia to very low levels and proceed to bone marrow transplantation. However, among patients whose leukemia was still active, CAR T-cell therapy was associated with better long-term survival after transplantation. The study also showed that patients with no detectable leukemia (MRD negativity) before transplantation had the best long-term outcomes regardless of which treatment they received.

What does this mean for people with ALL?

Taken together, these studies show that CAR T-cell therapy is becoming an increasingly important treatment option for people with ALL whose disease has relapsed or stopped responding to treatment. While still being studied, these new CAR T-cell therapies are producing high remission rates in both B-cell and T-cell ALL, even in heavily pre-treated patients. The findings also suggest that people with ALL do best when treatment reduces the number of leukemia cells to very low or undetectable levels before a bone marrow transplant. This means that achieving MRD negativity (where no leukemia cells can be detected using highly sensitive tests) is becoming an increasingly important treatment goal.

The studies also highlight that the timing and order of treatments matter. Patients who receive CAR T-cell therapy when they have lower levels of leukemia tend to have better outcomes, suggesting that targeted therapies and immunotherapies may play an important role before CAR T treatment. Bone marrow transplantation also remains an important part of treatment for many patients, particularly for those with relapsed or refractory disease. ‘Off-the-shelf’ CAR T-cells offer the possibility of treatments made from healthy donor cells that could reduce the time needed for treatment. Together, these findings help doctors better understand how to use CAR T-cell therapy most effectively, from agreeing a treatment plan with patients through to deciding if they may benefit from a transplant afterwards. As new CAR T-cell therapies continue to be developed and refined they may help expand treatment options for people with ALL in the future.

References

1. Zhang X. Presentation at the EHA 2026 Congress, Stockholm, Sweden, June 13, 2026. Abstract S110.
2. Roddie C. Presentation at the EHA 2026 Congress, Stockholm, Sweden, June 13, 2026. Abstract S113.
3. Jain N. Presentation at the EHA 2026 Congress, Stockholm, Sweden, June 13, 2026. Abstract S114.
4. Zhang A. Presentation at the EHA 2026 Congress, Stockholm, Sweden, June 13, 2026. Abstract S111.

Otsuka Pharmaceuticals Europe Ltd provided financial support through sponsorship for this EHA congress report. Otsuka has had no influence or involvement in the creation of the materials.