Chimeric Antigen Receptor T‐Cell Therapy Clinical Results in Pediatric and Young Adult B‐ALL
Open Access
- 1 August 2019
- journal article
- review article
- Published by Wiley in HemaSphere
- Vol. 3 (4), e279
- https://doi.org/10.1097/hs9.0000000000000279
Abstract
Chimeric antigen receptor (CAR)-modified T-cell therapy has revolutionized the care of patients with relapsed and refractory B-cell acute lymphoblastic leukemia (B-ALL). Results from clinical trials across multiple institutions report remarkable remission rates with CD19-directed CAR-modified T-cell therapy. These remissions are also proving to be durable in many patients with a relapse-free survival (RFS) of approximately 50% to 60% at 1 year across several trials and institutions in this population that has been historically very difficult to treat. In addition, new products are being developed to enhance upon the original CAR T-cell products, which include a humanized CAR, allogeneic CARs, and both CD22 and biallelic CD19 and CD22 constructs. Toxicity after CAR-modified T-cell therapy is characterized by cytokine release syndrome (CRS) and neurotoxicity in the acute post-infusion period and B-cell aplasia as a long-term consequence of treatment. This review will summarize the published data thus far on the use of CAR-modified T-cell therapy in pediatric B-ALL and outline the various CAR products now being developed for this population. Delivery of this therapy and the decision to pursue hematopoietic stem cell transplant (HSCT) after treatment will be discussed.This publication has 46 references indexed in Scilit:
- Chimeric Antigen Receptor–Modified T Cells for Acute Lymphoid LeukemiaThe New England Journal of Medicine, 2013
- How I treat relapsed childhood acute lymphoblastic leukemiaBlood, 2012
- Improved Survival for Children and Adolescents With Acute Lymphoblastic Leukemia Between 1990 and 2005: A Report From the Children's Oncology GroupJournal of Clinical Oncology, 2012
- Chimeric Antigen Receptor–Modified T Cells in Chronic Lymphoid LeukemiaThe New England Journal of Medicine, 2011
- Outcome of Patients Treated for Relapsed or Refractory Acute Lymphoblastic Leukemia: A Therapeutic Advances in Childhood Leukemia Consortium StudyJournal of Clinical Oncology, 2010
- Long-term results of the pediatric oncology group studies for childhood acute lymphoblastic leukemia 1984–2001: a report from the children's oncology groupLeukemia, 2009
- Long-term results of the children's cancer group studies for childhood acute lymphoblastic leukemia 1983–2002: A Children's Oncology Group ReportLeukemia, 2009
- Progress in Childhood Cancer: 50 Years of Research Collaboration, a Report From the Children's Oncology GroupSeminars in Oncology, 2008
- A Phase I Study on Adoptive Immunotherapy Using Gene-Modified T Cells for Ovarian CancerClinical Cancer Research, 2006
- Expression of immunoglobulin-T-cell receptor chimeric molecules as functional receptors with antibody-type specificity.Proceedings of the National Academy of Sciences of the United States of America, 1989