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Long-term follow-up of CD19 chimeric antigen receptor T-cell therapy for relapsed/refractory acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation
- Source :
- Cytotherapy. 22:755-761
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Background aims The efficacy of CD19-targeted chimeric antigen receptor T (CAR T) cells for treatment of relapsed B-cell malignancies after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and the long-term outcomes of these patients remain inconclusive. Methods The authors focused on the survival of 35 patients with B-cell acute lymphoblastic leukemia who relapsed after allo-HSCT and received CAR T cells. Results Of the 34 eligible patients, 30 achieved minimal residual disease-negative complete remission (CR), with a total CR rate of 85.7% (79.8–91.6%). There were 14 patients who received various forms of additional therapy after achieving CR. After a median follow-up of 20.7 months, it was noted that 17 patients had relapsed at a median of 4.5 months (2–34 months). The cumulative recurrence rate (RR) at 18 months was 68.3% (57.6–79.0%). Additional treatment did not reduce the RR but seemed to delay the time to relapse (mean: 5.9 months vs 13.1 months; P = 0.046). Patients with a lower tumor burden (≤10%) had a lower RR (25.0% vs 78.6% at 12 months; P = 0.006). The overall survival (OS) rate for the CR patients was 30.0% (20.3–29.7%) at 18 months, with a median OS of 12.7 months. Conclusions The authors’ study indicated that for patients who relapsed after HSCT, although a high CR rate was achieved after CAR T therapy, the long-term efficacy was unsatisfactory. It is necessary to optimize additional treatment, including a second HSCT, to further improve long-term efficacy after CAR T infusion.
- Subjects :
- Adult
Male
0301 basic medicine
Cancer Research
medicine.medical_specialty
Long term follow up
T-Lymphocytes
Lymphoblastic Leukemia
medicine.medical_treatment
Immunology
Receptors, Antigen, T-Cell
Hematopoietic stem cell transplantation
Immunotherapy, Adoptive
Gastroenterology
CD19
03 medical and health sciences
0302 clinical medicine
Recurrence
Cell Line, Tumor
Internal medicine
medicine
Humans
Immunology and Allergy
Genetics (clinical)
Cell Proliferation
B-Lymphocytes
Transplantation
biology
business.industry
Interleukins
Remission Induction
Hematopoietic Stem Cell Transplantation
Complete remission
Cell Biology
Middle Aged
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Prostate-Specific Antigen
Chimeric antigen receptor
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Relapsed refractory
biology.protein
Interleukin-2
Female
Chimeric Antigen Receptor T-Cell Therapy
business
Subjects
Details
- ISSN :
- 14653249
- Volume :
- 22
- Database :
- OpenAIRE
- Journal :
- Cytotherapy
- Accession number :
- edsair.doi.dedup.....61045b05e52ef38a40eceee1e38f860a