Chimeric antigen receptor T-cell therapy for ALL.

Abstract

Relapsed and refractory leukemias pose substantial challenges in both children and adults, with very little progress being made in more than a decade. Targeted immunotherapy using chimeric antigen receptor (CAR)-modified T cells has emerged as a potent therapy with an innovative mechanism. Dramatic clinical responses with complete remission rates as high as 90% have been reported using CAR-modified T cells directed against the B-cell-specific antigen CD19 in patients with relapsed/refractory acute lymphoblastic leukemia. Supraphysiologic T-cell proliferation, a hallmark of this therapy, contributes to both efficacy and the most notable toxicity, cytokine release syndrome, posing a unique challenge for toxicity management. Further studies are necessary to identify additional targets, standardize approaches to cytokine release syndrome management, and determine the durability of remissions.

• Authors: Shannon L Maude, Elizabeth J Shpall, Stephan A Grupp
• Journal: Hematology. American Society of Hematology. Education Program (Hematology Am Soc Hematol Educ Program) Vol. 2014 Issue 1 Pg. 559-64 (Dec 05 2014) ISSN: 1520-4383 [Electronic] United States
• PMID: 25696911 (Publication Type: Journal Article, Review)
• Copyright: © 2014 by The American Society of Hematology. All rights reserved.

Chemical References

• Antigens, CD19
• Receptors, Antigen, T-Cell

Topics

• Antigens, CD19 (immunology)
• Clinical Trials as Topic
• Humans
• Immunotherapy
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (immunology, therapy)
• Receptors, Antigen, T-Cell (immunology)
• T-Lymphocytes (immunology)
• Treatment Outcome