Pseudoprogression of extramedullary disease in relapsed acute lymphoblastic leukemia after CAR T-cell therapy

CD19-targeted chimeric antigen receptor (CAR) T-cell therapy has emerged as a powerful immunotherapy in relapsed or refractory B-cell acute lymphoblastic leukemia. The changes in extramedullary (EM) disease in pediatric relapsed or refractory B-cell acute lymphoblastic leukemia after CAR T-cell ther...

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Bibliographic Details
Published in:Immunotherapy 2021-01, Vol.13 (1), p.5-10
Main Authors: Huang, Jie, Rong, Liucheng, Wang, Enxiu, Fang, Yongjun
Format: Article
Language:English
Subjects:
Acute lymphoblastic leukemia
Antigens
Asymptomatic
Biopsy
Bone marrow
Cancer therapies
CD19
CD19 antigen
Cell therapy
Chemotherapy
child
chimeric antigen receptor-modified T-cell therapy
Chimeric antigen receptors
Cytokines
extramedullary
Immunotherapy
Kidneys
Leukemia
Lymphatic leukemia
Lymphocytes
Lymphocytes B
Lymphocytes T
Medical imaging
Medical prognosis
Minimal residual disease
Morphology
Mutation
Patients
Pediatrics
relapse
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Summary:CD19-targeted chimeric antigen receptor (CAR) T-cell therapy has emerged as a powerful immunotherapy in relapsed or refractory B-cell acute lymphoblastic leukemia. The changes in extramedullary (EM) disease in pediatric relapsed or refractory B-cell acute lymphoblastic leukemia after CAR T-cell therapy have rarely been reported. A child with relapsed B-ALL was treated with CAR T-cell therapy. Bone marrow morphological examination, minimal residual disease, fusion mutation and radiological evaluation of the EM disease were performed before and after CAR T-cell infusion. Radiological assessment revealed a distinct asymptomatic pseudo progression of EM involvements on day 16 after CAR T-cell infusion. Pseudoprogression of EM disease indicates heterogeneous immune-related patterns of response in patients treated with CAR-T therapy. Such patients should be closely monitored and practical immune-related response criteria should be developed for them.
ISSN:1750-743X
1750-7448
DOI:10.2217/imt-2020-0188