Abstract
This study aimed to evaluate treatment response, survival, safety profiles, and predictive factors to chimeric antigen receptor T cell (CAR-T) therapy in Chinese patients with relapsed or refractory B cell acute lymphoblast leukemia (R/R B-ALL). 39R/R B-ALL patients who underwent CAR-T therapy were included. Baseline data were collected from patients’ electronic medical records. Patients’ peripheral bloods, bone marrow aspirates, and biopsies were obtained for routine examination, and treatment response and survival profiles as well as adverse events were evaluated. The rates of complete remission (CR), CR with minimal residual disease (MRD) negative/positive, and bridging to hematopoietic stem-cell transplantation (HSCT) were 92.3%, 76.9%, 15.4%, and 43.6%, respectively. The median event-free survival (EFS) was 11.6 months (95% confidence interval (CI): 4.0–19.2 months) and median overall survival (OS) was 14.0 months (95% CI: 10.9–17.1 months). Bridging to HSCT independently predicted better EFS and OS, while high bone marrow blasts level independently predicted worse EFS. The incidence of cytokine release syndrome (CRS) was 97.4%, and refractory disease as well as decreased white blood cell independently predicted higher risk of severe CRS. Other common adverse events included hematologic toxicities (grade I: 5.1%, grade II: 7.7%, grade III: 17.9%, grade IV: 69.2%), neurotoxicity (28.2%), infection (38.5%), and admission for intensive care unit (10.3%). In conclusion, CAR-T therapy presents with promising treatment response, survival and safety profiles, and higher disease burden predicts worse survival as well as increased risk of severe CRS in Chinese R/R B-ALL patients.
Highlights
Acute lymphoblastic leukemia (ALL), a heterogeneous hematological malignancy commonly arising from B cell precursor linage (B-ALL) and less commonly from T cell precursor linage (T-ALL), occurs in all ages but mostOfficial journal of the Cell Death Differentiation AssociationLi et al Cell Death and Disease (2020)11:207 hard to be resolved by conventional salvage chemotherapy (complete remission (CR) lower than 30% and median overall survival (OS) of 4 months), or even HSCT4–6
The survival profiles of R/R B-ALL patients have been improved by CAR-T therapy, but with inevitable adverse events (such as cytokine release syndrome (CRS), B cell aplasia, neurotoxicity, and tumor lysis syndrome)[15,16]
Tumor-associated antigen is presented by antigen-presenting cells (APCs) that are matured from dendric cells, and IL-12 is released to activate type I CD4+ T helper cells
Summary
Acute lymphoblastic leukemia (ALL), a heterogeneous hematological malignancy commonly arising from B cell precursor linage (B-ALL) and less commonly from T cell precursor linage (T-ALL), occurs in all ages but mostOfficial journal of the Cell Death Differentiation AssociationLi et al Cell Death and Disease (2020)11:207 hard to be resolved by conventional salvage chemotherapy (complete remission (CR) lower than 30% and median OS of 4 months), or even HSCT4–6. Chimeric antigen receptor T cell (CAR-T) therapy is an adoptive cellular therapy that has achieved remarkable advances beyond conventional chemotherapies[7]. It genetically engineers patient-originated T cells to express an extracellular antigen-binding domain that binds cancer-specific antigens independent of major histocompatibility complex (MHC) and intracellular T cell signaling domain that leads to T cell activation and destruction of malignant cells[1]. The study does not investigate the survival profiles or factors influencing the clinical outcomes by CAR-T therapy, leaving them still obscure in Chinese R/R B-ALL patients
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
