Bader P, Rossig C, Hutter M, et al. CD19-CAR-T Cells Are an Effective Therapy of Post-Transplant Relapse in B-ALL Patients: Real-World Data from Germany. Blood Advances. 2023; (doi: 10.1182/bloodadvances.2022008981).
A real-world study of pediatric, adolescent, and young adult patients found that a single infusion of CD19-targeted chimeric antigen receptor (CAR)-T cells can effectively treat most cases of B cell acute lymphoblastic leukemia (B-ALL) who relapse >6 months following allogeneic stem cell transplantation (alloHSCT). The retrospective study included 81 patients with precursor B-ALL (pB-ALL), 65 of whom had received prior alloHSCT, received an infusion of tisagenlecleucel (tisa-cel) CAR-T cells. By 28 days post-infusion, 87.7% (N=71) of the patients had a complete remission (CR), while 9.9% (N=8) had no response (NR). The probabilities of event-free survival (pEFS), relapse-free survival (pRFS), and overall survival (pOS) 2 years after infusion were 45.3%, 51.7%, and 53.2%, respectively. The rate of pEFS did not differ between patients with and without prior alloHSCT. The time to relapse in patients who underwent alloHSCT strongly correlated with outcome. Those relapsing within 6 months of transplant had a pEFS (pOS) of 18.4% (16.0%), while the rate for those relapsing later was 55.5% (74.8%). Excellent survival probability for patients who relapsed more than 6 months post-alloHSCT and poor probability for those who relapsed earlier could inform clinical decision-making and inspire research to explore the reasons why.
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