Use of cardiac radiation therapy as bridging therapy to CAR‐T for relapsed pediatric B‐cell acute lymphoblastic leukemia

The use of radiotherapy as bridging therapy to chimeric antigen receptor T‐cell therapy (CAR‐T) in pre‐B acute lymphoblastic leukemia (B‐ALL) has been minimally explored. Here, we present a boy with B‐ALL who relapsed after allogeneic bone marrow transplant with disseminated disease, including signi...

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Bibliographic Details
Published in:Pediatric blood & cancer 2021-03, Vol.68 (3), p.e28870-n/a
Main Authors: Marquez, Cesar P., Montiel‐Esparza, Raul, Hui, Caressa, Schultz, Liora M., Davis, Kara L., Hoppe, Richard T., Donaldson, Sarah S., Ramakrishna, Sneha, Hiniker, Susan M.
Format: Article
Language:English
Subjects:
Acute lymphoblastic leukemia
Bone marrow transplantation
B‐ALL
CAR‐T
Cell therapy
Chimeric antigen receptors
Complications
Hematology
Leukemia
Lymphatic leukemia
Oncology
pediatric oncology
Pediatrics
Radiation therapy
radiotherapy
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Summary:The use of radiotherapy as bridging therapy to chimeric antigen receptor T‐cell therapy (CAR‐T) in pre‐B acute lymphoblastic leukemia (B‐ALL) has been minimally explored. Here, we present a boy with B‐ALL who relapsed after allogeneic bone marrow transplant with disseminated disease, including significant symptomatic cardiovascular and gastrointestinal (GI) involvement. The cardiac and GI leukemic infiltrates were successfully treated with bridging radiation therapy (BRT) prior to CAR‐T infusion. Using this approach, he successfully tolerated CAR‐T with no evidence of disease or sequelae on 3‐month follow‐up. This is the first reported case of safe and effective delivery of cardiac BRT in B‐ALL.
ISSN:1545-5009
1545-5017
DOI:10.1002/pbc.28870