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10.1182/blood-2017-02-769208

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suck abstract from ncbi


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pmid28408462
      Blood 2017 ; 129 (25 ): 3322-3331
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  • Intent-to-treat leukemia remission by CD19 CAR T cells of defined formulation and dose in children and young adults #MMPMID28408462
  • Gardner RA ; Finney O ; Annesley C ; Brakke H ; Summers C ; Leger K ; Bleakley M ; Brown C ; Mgebroff S ; Kelly-Spratt KS ; Hoglund V ; Lindgren C ; Oron AP ; Li D ; Riddell SR ; Park JR ; Jensen MC
  • Blood 2017[Jun]; 129 (25 ): 3322-3331 PMID28408462 show ga
  • Transitioning CD19-directed chimeric antigen receptor (CAR) T cells from early-phase trials in relapsed patients to a viable therapeutic approach with predictable efficacy and low toxicity for broad application among patients with high unmet need is currently complicated by product heterogeneity resulting from transduction of undefined T-cell mixtures, variability of transgene expression, and terminal differentiation of cells at the end of culture. A phase 1 trial of 45 children and young adults with relapsed or refractory B-lineage acute lymphoblastic leukemia was conducted using a CD19 CAR product of defined CD4/CD8 composition, uniform CAR expression, and limited effector differentiation. Products meeting all defined specifications occurred in 93% of enrolled patients. The maximum tolerated dose was 10(6) CAR T cells per kg, and there were no deaths or instances of cerebral edema attributable to product toxicity. The overall intent-to-treat minimal residual disease-negative (MRD(-)) remission rate for this phase 1 study was 89%. The MRD(-) remission rate was 93% in patients who received a CAR T-cell product and 100% in the subset of patients who received fludarabine and cyclophosphamide lymphodepletion. Twenty-three percent of patients developed reversible severe cytokine release syndrome and/or reversible severe neurotoxicity. These data demonstrate that manufacturing a defined-composition CD19 CAR T cell identifies an optimal cell dose with highly potent antitumor activity and a tolerable adverse effect profile in a cohort of patients with an otherwise poor prognosis. This trial was registered at www.clinicaltrials.gov as #NCT02028455.
  • |Adolescent [MESH]
  • |Adult [MESH]
  • |Antigens, CD19/*immunology [MESH]
  • |CD4-Positive T-Lymphocytes/immunology/*transplantation [MESH]
  • |CD8-Positive T-Lymphocytes/immunology/*transplantation [MESH]
  • |Child [MESH]
  • |Child, Preschool [MESH]
  • |Female [MESH]
  • |Humans [MESH]
  • |Infant [MESH]
  • |Male [MESH]
  • |Neoplasm Recurrence, Local/immunology/*therapy [MESH]
  • |Precursor Cell Lymphoblastic Leukemia-Lymphoma/immunology/*therapy [MESH]
  • |Receptors, Antigen, T-Cell/*immunology [MESH]
  • |Remission Induction [MESH]


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