Tisagenlecleucel, an advanced immunotherapy, is now recommended for inclusion on the Singapore Ministry of Health’s Cell, Tissue, and Gene Therapy Product (CTGTP) List for acute lymphoblastic leukemia (ALL). This decision ensures government funding for patients with relapsed or refractory B-cell acute lymphoblastic leukemia, provided they meet specific clinical criteria. This recommendation marks a significant step towards making cutting-edge treatments more accessible to those in need.
Acute lymphoblastic leukemia is a rapidly progressing cancer affecting blood and bone marrow, leading to uncontrolled growth of white blood cells, known as “leukemia cells.” This proliferation reduces space for healthy blood cells, causing susceptibility to anemia and infections. ALL has different subtypes, with B-cell ALL being the most common, especially in children and adults. Understanding the nature and progression of ALL is crucial for developing effective treatment strategies.
Symptoms of B-cell ALL include gum bleeding, bone pain, fever, frequent infections, pale skin, weakness, and shortness of breath. Although many patients achieve remission with chemotherapy, relapse or refractory cases require alternative treatments. A potential option for some is a stem cell transplant, which can restore bone marrow and rebuild the immune system after high-dose chemotherapy. The choice of treatment depends on several factors, including the patient’s overall health and previous treatment responses.
Tisagenlecleucel: A New Hope for Leukemia Patients
Tisagenlecleucel, a type of CAR-T therapy, offers a one-time treatment option involving several weeks of procedures. Blood is drawn to collect T-cells, which are genetically modified in a laboratory and reintroduced into the patient’s bloodstream. These modified cells target and kill cancer cells, with close monitoring required during and after treatment. The process is intricate and requires precision, but it has shown promising results in clinical trials.
Suitable for patients aged 2 to 25 with B-cell ALL unresponsive to previous treatments, tisagenlecleucel can also be used after relapse post-transplant or after at least two previous treatments. Doctors will assess suitability based on individual patient health and treatment history. This personalized approach ensures that each patient receives the most appropriate care for their specific condition.
Leukemia and Its Impact
The Agency for Care Effectiveness (ACE) evaluates treatments for effectiveness and cost-efficiency. Tisagenlecleucel was deemed an acceptable use of healthcare resources at the proposed price. Inclusion on the MOH CTGTP List means that prescribed treatments will be subsidized, easing the financial burden on patients and their families. This subsidy is crucial for making high-cost therapies like CAR-T more accessible to a broader population.
The recommendation to fund tisagenlecleucel for relapsed or refractory B-cell acute lymphoblastic leukemia represents a significant advancement in cancer treatment. By addressing both clinical effectiveness and cost-efficiency, this decision highlights the importance of balancing innovation with sustainability in healthcare. Patients and their families can look forward to improved outcomes and quality of life, knowing that cutting-edge treatments are within reach.
Resource: Agency for Care Effectivenes, August 01, 2024

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