Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the availability of treatments for patients diagnosed with Refractory B-cell Acute Lymphoblastic Leukaemia.

The following treatments are routinely available, having undergone Technical Appraisals by the National Institute for Health and Care Excellence (NICE). They were previously accessible through the Cancer Drugs Fund.

- Blinatumomab for relapsed refractory (r/r) Philadelphia negative acute lymphoblastic leukaemia (ALL); and

- Ponatinib for Philadelphia positive ALL in patients in whom imatinib is not clinically appropriate (which might cover some r/r).

The following treatments are currently under consideration by NICE:

- CAR-T (Tisagenlecleucel-T and also Axicabtagene ciloleucel) for previously treated B-cell ALL in people aged 3 to 21 at initial diagnosis;

- Inotuzumab ozogamicin for treating r/r ALL; and

- Blinatumomab in other extended indications in ALL.

Finally, the following treatments are currently accessible through the Cancer Drugs Fund.

- Clofarabine for treating ALL in children after two therapies; and

- Nelarabine for treating ALL after two therapies.

Information on the number and proportion of patients with refractory B-cell Acute Lymphoblastic Leukaemia who have been unable to access treatments for that condition is not held centrally.