Chimeric antigen receptor T cell therapy for pediatric and young adult B cell acute lymphoblastic leukemia.

Chimeric antigen receptor T cell therapy for pediatric and young adult B cell acute lymphoblastic leukemia. Expert Rev Clin Immunol. 2020 Sep 25;: Authors: Myers RM, Dolan JG, Teachey DT Abstract INTRODUCTION: Though 85% of children and young adults with acute lymphoblastic leukemia (ALL) are cured, the prognosis of relapsed or refractory disease is poor, with little progress made until recently. The advent of chimeric antigen receptor (CAR) T cell therapy has transformed treatment of relapsed/refractory ALL. The most well-studied, successful CARs are autologous, murine-based anti-CD19 CARs, but new CAR constructs are currently under clinical investigation. AREAS COVERED: This review describes the history and design of CAR T cells, clinical trial outcomes of anti-CD19 and newer CARs, treatment-related toxicities including cytokine release syndrome and neurotoxicity, and issues with resistance and relapse. A search of PubMed and clinicaltrials.gov spanning from 2012 to present was used to select original reports investigating use of CAR T in pediatric patients. EXPERT OPINION: CD19-targeted CARs have demonstrated remarkable response rates and produced durable remissions in very high-risk pediatric patient populations. The therapies, however, are limited by unique treatment-related toxicities and considerable rates of antigen-positive and antigen-negative relapses. Current research efforts focused on elucidating mechani...
Source: Expert Review of Clinical Immunology - Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research