Preventing relapse after CD19 CAR T-cell therapy for pediatric ALL: the role of transplant and enhanced CAR T cells

CD19-specific chimeric antigen receptor (CAR) T-cell therapy has become an integral part of our treatment armamentarium for pediatric patients with relapsed or refractory B-cell acute lymphoblastic leukemia (B-ALL). However, despite initial remission rates of greater than 80%, durable remission occu...

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Bibliographic Details
Published in:Hematology 2023-12, Vol.2023 (1), p.91-96
Main Authors: Talleur, Aimee C, Naik, Swati, Gottschalk, Stephen
Format: Article
Language:English
Subjects:
Antigens, CD19
CAR T Cells in ALL: Bridge or Definitive Therapy?
Child
Hematopoietic Stem Cell Transplantation
Humans
Immunotherapy, Adoptive - adverse effects
Precursor B-Cell Lymphoblastic Leukemia-Lymphoma - therapy
Receptors, Chimeric Antigen
Recurrence
T-Lymphocytes
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Summary:CD19-specific chimeric antigen receptor (CAR) T-cell therapy has become an integral part of our treatment armamentarium for pediatric patients with relapsed or refractory B-cell acute lymphoblastic leukemia (B-ALL). However, despite initial remission rates of greater than 80%, durable remission occurs in only 40% to 50% of patients. In this review we summarize our current knowledge of the role of consolidative hematopoietic cell transplantation in the management of pediatric patients who achieved a minimal residual disease-negative complete response post CD19 CAR T-cell therapy. In addition, we review approaches to enhance effector function CD19 CAR T cells, focusing on how to improve persistence and prevent the emergence of CD19- B-ALL blasts.
ISSN:1520-4391
1520-4383
1520-4383
DOI:10.1182/hematology.2023000424