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Moskop, Amy; Pommert, Lauren; Baggott, Christina; Prabhu, Snehit; Pacenta, Holly L.; Phillips, Christine L.; Rossoff, Jenna; Stefanski, Heather; Talano, Julie-An; Margossian, Steve P.; Verneris, Michael R.; Myers, G. Doug; Karras, Nicole A.; Brown, Patrick A.; Qayed, Muna; Hermiston, Michelle L.; Satwani, Prakash; Krupski, Christa; Keating, Amy K.; Wilcox, Rachel; Rabik, Cara A.; Fabrizio, Vanessa A.; Chinnabhandar, Vasant; Goksenin, A. Yasemin; Curran, Kevin J.; Mackall, Crystal L.; Laetsch, Theodore W.; Guest, Erin M.; Breese, Erin H.; Schultz, Liora M.
Blood advances, 07/2022, Volume: 6, Issue: 14Journal Article
Infants with B-cell acute lymphoblastic leukemia (B-ALL) have poor outcomes due to chemotherapy resistance leading to high relapse rates. Tisagenlecleucel, a CD19-directed chimeric antigen receptor T-cell (CART) therapy, is FDA approved for relapsed or refractory (R/R) B-ALL in patients <25 years; however, the safety and efficacy of this therapy in young patients is largely unknown since children <3 years of age were excluded from licensing studies. We retrospectively evaluated data from the Pediatric Real-World CAR Consortium to examine outcomes of patients with infant B-ALL who received tisagenlecleucel between 2017 and 2020 (n=14). Sixty-four percent of patients (n=9) achieved minimal residual disease (MRD)-negative remission post-CART and 50% of patients remain in remission at last follow-up. All patients with high disease burden at time of CART infusion (>M1 marrow) were refractory to this therapy (n=5). Overall, tisagenlecleucel was tolerable in this population, with only 3 patients experiencing ≥ grade 3 cytokine release syndrome. No neurotoxicity was reported. This is the largest report of tisagenlecleucel use in infant B-ALL and shows that this therapy is safe and can be effective in this population. Incorporating this novel immunotherapy into the treatment of infant B-ALL offers a promising therapy for a highly aggressive leukemia.
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