TY - JOUR
T1 - Chimeric Antigen Receptor T-Cells in B-Acute Lymphoblastic Leukemia
T2 - State of the Art and Future Directions
AU - Greenbaum, Uri
AU - Mahadeo, Kris Michael
AU - Kebriaei, Partow
AU - Shpall, Elizabeth J.
AU - Saini, Neeraj Y.
N1 - Funding Information:
The authors are grateful to Ms. Tamara Locke from the Department of Scientific Publications, The University of Texas MD Anderson Cancer Center, for editorial support. Dr. Greenbaum is a recipient of a fellowship Grant from the American Physicians' Fellowship for Medicine in Israel (APF).
Publisher Copyright:
© Copyright © 2020 Greenbaum, Mahadeo, Kebriaei, Shpall and Saini.
PY - 2020/8/26
Y1 - 2020/8/26
N2 - Use of adoptive T-cell therapy modified with chimeric antigen receptor (CAR-T) has revolutionized treatment of patients with relapsed/refractory (r/r) B-cell acute lymphoblastic leukemia (B-ALL). CAR-T cells directed against CD19 antigen have produced response rates as high as 90% in clinical trials for r/r B-ALL. Despite high rates of complete remissions, the durability of responses has been sub-optimal with frequent relapses, especially in adult B-ALL population. Systemic toxicities from CAR-T therapy and standardization of toxicities grading and management is another major hurdle in the development of CAR-T field. In this review, we discuss the latest evidence of CAR-T therapy in B-ALL, potential mechanisms of relapse and barriers to CAR-T cell therapy in B-ALL. We also debate the role of allogeneic hematopoietic stem cell transplant (allo-HCT) post CAR-T therapy.
AB - Use of adoptive T-cell therapy modified with chimeric antigen receptor (CAR-T) has revolutionized treatment of patients with relapsed/refractory (r/r) B-cell acute lymphoblastic leukemia (B-ALL). CAR-T cells directed against CD19 antigen have produced response rates as high as 90% in clinical trials for r/r B-ALL. Despite high rates of complete remissions, the durability of responses has been sub-optimal with frequent relapses, especially in adult B-ALL population. Systemic toxicities from CAR-T therapy and standardization of toxicities grading and management is another major hurdle in the development of CAR-T field. In this review, we discuss the latest evidence of CAR-T therapy in B-ALL, potential mechanisms of relapse and barriers to CAR-T cell therapy in B-ALL. We also debate the role of allogeneic hematopoietic stem cell transplant (allo-HCT) post CAR-T therapy.
KW - B-ALL
KW - CAR-T therapy
KW - acute lymphoblastic leukemia
KW - allogeneic transplant after CAR-T therapy
KW - chimeric antigen receptor
KW - relapse after CAR-T therapy
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U2 - 10.3389/fonc.2020.01594
DO - 10.3389/fonc.2020.01594
M3 - Review article
C2 - 32984022
AN - SCOPUS:85090558401
SN - 2234-943X
VL - 10
JO - Frontiers in Oncology
JF - Frontiers in Oncology
M1 - 1594
ER -