Low toxicity and favorable overall survival in relapsed/refractory B-ALL following CAR T cells and CD34-selected T-cell depleted allogeneic hematopoietic cell transplant Journal Article
| Authors: | Fabrizio, V. A.; Kernan, N. A.; Boulad, F.; Cancio, M.; Allen, J.; Higman, M.; Margossian, S. P.; Mauguen, A.; Prockop, S.; Scaradavou, A.; Shah, N.; Spitzer, B.; Stieglitz, E.; Yeager, N.; O’Reilly, R. J.; Brentjens, R. J.; Boelens, J. J.; Curran, K. J. |
| Article Title: | Low toxicity and favorable overall survival in relapsed/refractory B-ALL following CAR T cells and CD34-selected T-cell depleted allogeneic hematopoietic cell transplant |
| Abstract: | To define the tolerability and outcome of allogeneic hematopoietic stem cell transplant (allo-HSCT) following CAR T-cell therapy, we retrospectively reviewed pediatric/young adult patients with relapsed/refractory B-ALL who underwent this treatment. Fifteen patients (median age 13 years; range 1–20 years) with a median potential follow-up of 39 months demonstrated 24-month cumulative incidence of relapse, cumulative incidence of TRM, and OS of 16% (95% CI: 0–37%), 20% (95% CI: 0–40%), and 80% (95% CI: 60–100%), respectively. Severe toxicity following CAR T cells did not impact OS (p = 0.27), while greater time from CAR T cells to allo-HSCT (>80 days) was associated with a decrease in OS. In comparing CD34-selected T-cell depleted (TCD; n = 9) vs unmodified (n = 6) allo-HSCT, the cumulative incidence of relapse, TRM, and OS at 24 months was 22% (95% CI: 0–49%) vs 0% (p = 0.14), 0% vs 50% [95% CI: 10–90%] (p = 0.02) and 100% vs 50% [95% CI: 10–90%] (p = 0.02). In this small cohort of patients, CAR T cells followed by a CD34-selected TCD allo-HSCT appears to result in less TRM and favorable OS when compared with unmodified allo-HSCT. There was no evidence that disease control was impacted by the type of consolidative allo-HSCT, which demonstrates the feasibility of this approach. © 2020, The Author(s), under exclusive licence to Springer Nature Limited. |
| Journal Title: | Bone Marrow Transplantation |
| Volume: | 55 |
| Issue: | 11 |
| ISSN: | 0268-3369 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2020-11-01 |
| Start Page: | 2160 |
| End Page: | 2169 |
| Language: | English |
| DOI: | 10.1038/s41409-020-0926-1 |
| PUBMED: | 32390002 |
| PROVIDER: | scopus |
| PMCID: | PMC7606268 |
| DOI/URL: | |
| Notes: | MSK author Joseph Olechnowicz is thanked in the acknowledgements for editorial assistance -- Article -- Export Date: 1 December 2020 -- Source: Scopus |
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