CD19-Specific CAR-T Therapy Shows Promise in B-Cell ALL with CNSL

By Leah Sherwood - Last Updated: June 29, 2022

A retrospective study demonstrated the potential of CD19 chimeric antigen receptor (CAR) T-cell therapy as a treatment option for previously excluded patients with central nervous system leukemia (CNSL), according to a study published in Blood.

“CD19-specific CAR T-cell therapy provides a potential treatment option for a cohort of previously excluded patients with CNSL with otherwise poor prognosis,” wrote the authors, led by Yuekun Qi, of the Xuzhou Medical University in China.

The study enrolled 48 patients with relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL) with CNSL in China. The median age was 31 years (range, 6-68 years), with more than 60% of the patients younger than 40 years old. A total of 36 patients had bone marrow (BM) and CNS disease, while 12 had isolated CNS disease. Patients had received a median of four prior treatments (range, 3-16 treatments).

Among the enrolled patients, 37 (77.1%) received isolated anti-CD19 CAR T-cells, while 11 (22.9%) received combined anti-CD19 and anti-CD22 CAR T-cells.

The treatment produced an overall response rate of 87.5% in those with BM disease and a remission rate of 85.4% in patients with CNSL. With a median follow-up of 11.5 months (range, 1.3-33.3 months), the median event-free survival was 8.7 months, and the median overall survival was 16 months. The cumulative incidences of relapse in BM and CNS diseases at 12 months were 31.1% and 11.3%, respectively.

“Our results suggest that CD19-specific CAR T-cell–based therapy can induce similar high response rates in both BM and CNS diseases,” the authors concluded.

Dr. Qi and colleagues noted that the trial was limited by the nature of the retrospective analysis and “by incomplete information on CAR T-cell kinetics in the CNS.” They added that their study did not address the dose and timing of different bridging therapies administered before CAR T-cell therapy.

Reference: Qi Y, Zhao M, Hu Y, et al. Efficacy and safety of CD19-specific CAR T cell-based therapy in B-cell acute lymphoblastic leukemia patients with CNSL. Blood. 2022;139(23):3376-3386.

Post Tags:CAR T-cell therapyCNS
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