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Posted by on May 16, 2020 in Leukemia | 0 comments

In a nutshell

This study aimed to investigate the outcomes of anti-CD19 chimeric antigen receptor T cells in patients with relapsed or refractory (unresponsive) chronic lymphocytic leukemia. 

This study concluded that high-dose treatment may be more effective in these patients in the long term.  

Some background

Chimeric antigen receptor T (CART) cells are a type of immunotherapy that uses modified T cells to fight cancer. Patients' T cells are collected from blood, modified in a laboratory, and reintroduced to the body.  Anti-CD19 CART cells are one type of these cells. 

It was unknown if anti-CD19 CART cells are effective in patients with relapsed/refractory chronic lymphocytic leukemia (CLL) in the long-term. 

Methods & findings

This study involved 42 patients with relapsed or refractory CLL. 38 patients received anti-CD19 CART cells (CART-19). Patients were randomly assigned to receive low dose or high dose CART-19. Patients were followed for an average of 31.5 months.  

At 4 weeks, the complete response (CR; no signs of cancer) rate for all patients was 28%. At 4 weeks, the overall response (OR) rate for all patients was 44%. 

The average overall survival (OS) for all patients was 64 months. There was no significant difference in OS between high- and low-dose groups. Regardless of dose, patients who achieved a CR had better survival when compared to those who did not achieve CR. The average progression-free survival (PFS; survival without cancer worsening) was 40.2 months in patients with a CR compared to 1 month for patients without CR.  

Toxicity was similar in both the high- and low-dose groups. The most common side effects were cytokine release syndrome (CRS; a strong inflammatory response from the body) and low white blood cell counts.

The bottom line

This study concluded that high-dose anti-CD19 CART treatment may be more effective than low-dose in patients with CLL. It was also concluded that regardless of dose, attaining CR after treatment, leads to longer OS and PFS in relapsed patients. 

The fine print

This study had a small number of participants. Larger studies are needed to confirm these results. Also, this study was partially funded by the Pharma Industry.

Published By :

Journal of clinical oncology

Date :

Apr 16, 2020

Original Title :

Long-Term Outcomes From a Randomized Dose Optimization Study of Chimeric Antigen Receptor Modified T Cells in Relapsed Chronic Lymphocytic Leukemia.

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