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Advances in T-cell therapy for ALL.

Stephan A Grupp1

  • 1Perelman School of Medicine, University of Pennsylvania, USA; Center for Childhood Cancer Research, Children's Hospital of Philadelphia, USA.

Best Practice & Research. Clinical Haematology
|December 3, 2014
PubMed
Summary
This summary is machine-generated.

Chimeric antigen receptor T cell (CART19) therapy shows high success rates in treating leukemia patients. This immunotherapy is a promising alternative to traditional transplant methods.

Keywords:
ALLCLLIL-6acute lymphocytic leukemiachimeric antigen receptorchronic lymphocytic leukemiacytokine release syndromemacrophage activation syndrome

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Area of Science:

  • Immunotherapy
  • Hematology
  • Oncology

Background:

  • CD19-directed chimeric antigen receptor T cells (CART19) are effective in treating acute lymphocytic leukemia (ALL) and chronic lymphocytic leukemia (CLL).
  • Existing toxicities like cytokine release syndrome are manageable with IL-6 blockade (e.g., tocilizumab).

Purpose of the Study:

  • To evaluate the efficacy and safety of CART19 therapy in high-risk leukemia patients.
  • To assess the potential of CART19 as a standalone treatment or alternative to stem cell transplantation.

Main Methods:

  • Infusion of CART19 (CTL019) cells in patients with relapsed/refractory ALL and CLL.
  • Monitoring for treatment response and adverse events, including cytokine release syndrome and macrophage activation syndrome.

Main Results:

  • Achieved a 90% complete response rate in very high-risk patients previously refractory to multiple therapies and/or transplant.
  • Demonstrated manageable toxicities reversible with tocilizumab treatment.

Conclusions:

  • CART19 therapy offers a highly effective treatment option for leukemia patients, including those with poor prognoses.
  • Improved cell persistence suggests CART19 may serve as a transplant alternative, not just a bridge therapy.