Aug 11, 2026 · 29 min · 12 segments
Some of the most serious diagnoses in pediatrics begin with common pediatric symptoms. A child comes in looking pale or with a febrile illness. They've been more tired than usual. Maybe they're…
Ashley RogersGuestDavid BrumbaughHostHow does that fit into your algorithm and your armamentarium, if you will, of treatments for canc- for this type of cancer?
One of the newest treatments that is becoming more routine, that m- many, many children are getting, is a new medication called blinatumomab, and that is a molecule that actually connects, it helps connects the CD19 marker on a B cell to the CD3 marker on T cells that are killer cells.
It actually can connect them physically so that it makes the cancer cells easier to kill.
And there were studies in the beginning, this was initially used for children at time of relapse, but now we're using it for more children up front.
So children who are standard risk or have higher risk features are getting blinatumomab right from the get-go, and that's been a, a hugely transformative therapy in, in the recent past.
And then the other piece I think, um, uh, people have heard about a lot are, is called CAR T cells.
Those are more reserved, so that's an actual engineering of a patient's own T cells to be reinfused and hunt down those leukemia cells.
That's more reserved for children with refractory or relapse disease, but that's, I think, another upcoming and, and very promising therapy that's being used now.
So, you know, these patients, if they're diagnosed with ALL, they go into this intensive six months of therapy, this very close relationship with the oncology team that's caring for them.
Um, and, and all that is, you know, incredibly protocolized and stressful and demanding for the families for sure.
What is the role at that point, would you say, for the primary care team? And, uh, because so much of it-
... is happening at the cancer treatment center, what, what is the, what do you expect the primary care provider be doing during this intensive phase and even the next 18 months after that?
I think when a pediatrician and a, a patient and their family have a wonderful relationship with, which so many of them do, I think it's incredibly helpful for families.
I think they thrive through this experience better to have someone else to bounce questions and ideas off of.
In the very beginning, most children are coming into oncology clinic twice a week, so the time to have another additional visit is, is slim, and most questions are answered in that time in terms of acute needs and infections.
Uh, but I think as time goes on, especially in maintenance, children are not in oncology clinic as much, and I think their questions can really wonderfully be ans- answered in their pediatric office.
How does that fit into your algorithm and your armamentarium, if you will, of treatments for canc- for this type of cancer?
One of the newest treatments that is becoming more routine, that m- many, many children are getting, is a new medication called blinatumomab, and that is a molecule that actually connects, it helps connects the CD19 marker on a B cell to the CD3 marker on T cells that are killer cells.
It actually can connect them physically so that it makes the cancer cells easier to kill.
And there were studies in the beginning, this was initially used for children at time of relapse, but now we're using it for more children up front.
So children who are standard risk or have higher risk features are getting blinatumomab right from the get-go, and that's been a, a hugely transformative therapy in, in the recent past.
And then the other piece I think, um, uh, people have heard about a lot are, is called CAR T cells.
Those are more reserved, so that's an actual engineering of a patient's own T cells to be reinfused and hunt down those leukemia cells.
That's more reserved for children with refractory or relapse disease, but that's, I think, another upcoming and, and very promising therapy that's being used now.
So, you know, these patients, if they're diagnosed with ALL, they go into this intensive six months of therapy, this very close relationship with the oncology team that's caring for them.
Um, and, and all that is, you know, incredibly protocolized and stressful and demanding for the families for sure.
What is the role at that point, would you say, for the primary care team? And, uh, because so much of it-
... is happening at the cancer treatment center, what, what is the, what do you expect the primary care provider be doing during this intensive phase and even the next 18 months after that?
I think when a pediatrician and a, a patient and their family have a wonderful relationship with, which so many of them do, I think it's incredibly helpful for families.
I think they thrive through this experience better to have someone else to bounce questions and ideas off of.
In the very beginning, most children are coming into oncology clinic twice a week, so the time to have another additional visit is, is slim, and most questions are answered in that time in terms of acute needs and infections.
Uh, but I think as time goes on, especially in maintenance, children are not in oncology clinic as much, and I think their questions can really wonderfully be ans- answered in their pediatric office.
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