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Fluorescence-activated Cell Sorting for Purification of Plasmacytoid Dendritic Cells from the Mouse Bone Marrow
Published on: November 4, 2016
First pediatric experience of SL-401, a CD123-targeted therapy, in patients with blastic plasmacytoid dendritic cell
Weili Sun1, Huaying Liu2,3, Young Kim4
1Department of Pediatrics, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA. weilisun@coh.org.
Insights
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare cancer. SL-401 shows promise as a well-tolerated targeted therapy for children with BPDCN, demonstrating transient responses in some cases.
Area of Science:
- Hematology
- Oncology
- Pediatric Oncology
Background:
- Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an aggressive hematologic malignancy with poor prognosis.
- Current treatment options for pediatric BPDCN are limited and lack standardization.
- SL-401 targets CD123, a protein highly expressed on BPDCN cells, showing efficacy in adult trials.
Observation:
- This study presents the first pediatric experience with SL-401 in three children diagnosed with BPDCN.
- All patients tolerated SL-401 treatment without significant adverse events.
- One patient with refractory disease did not respond to SL-401.
Findings:
- Two out of three pediatric patients experienced rapid clinical improvement after SL-401 treatment.
- Observed responses were transient, with tumor regrowth noted between treatment cycles in patients with high tumor burden.
- SL-401 was generally well-tolerated in the pediatric cohort.
Implications:
- SL-401 demonstrates potential as a targeted therapy for pediatric BPDCN.
- Further investigation of SL-401 in pediatric BPDCN is warranted.
- Understanding response duration and managing tumor burden are key for future pediatric trials.
Background:
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a highly aggressive hematological malignancy with extremely poor outcome. The median overall survival for adult patients is 9-13 months. Pediatric patients are exceedingly rare with an unclear clinical course. Currently, no standardized therapy has been established, although an acute lymphoblastic leukemia type of treatment appears to be more effective in those patients who are able to tolerate aggressive chemotherapy. SL-401 is a targeted therapy directed to CD123, a protein ubiquitously expressed at high level on the surface of BPDCN blasts. In adult phase 2 trials, it has demonstrated efficacy with 90% overall response rate. No pediatric patients with BPDCN using SL-401 have been reported.
Case Presentation:
Here, we report the first pediatric experience of three children with BPDCN treated with SL-401 at our institution. All patients tolerated SL-401 without significant toxicities. One patient with multiply relapsed and refractory disease had no response. The other two cases had significant and rapid clinical improvement after the two courses of treatment. However, the response was transient, and growth of soft tissue mass was observed in-between cycles in both patients with large tumor burden.
Conclusions:
This is the first report of SL-401 in pediatric patients with BPDCN. Sl-401 was well tolerated and can produce a promising response. Further testing this agent in children is warranted.
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