Approaches for bridging therapy prior to chimeric antigen receptor T cells for relapsed/refractory acute lymphoblastic B-lineage leukaemia in children and young adults

  • The ongoing development of immunotherapies, including chimeric antigen receptor (CAR) T cells, has revolutionized cancer treatment. In pediatric relapsed/refractory B-lineage acute leukemia antiCD19-CAR induce impressive initial response rates, with event-free survival plateauing at 30-50% according to long-term follow-up data. During the interval between diagnosis of relapse or refractoriness and CAR T-cell infusion, patients require a bridging therapy. To date, this therapy has consisted of highly variable approaches based on local experience. Here, in an European collaborative effort of pediatric and adult hematologists, we summarize current knowledge with the aim of establishing guidance for bridging therapy. We discuss treatment strategies for different subgroups of patients, the advantages and disadvantages of low- and high-intensity regimens, and the potential impact of bridging therapy on outcomes after CAR T-cell infusion. This guidance is a step towards cross-institutionalThe ongoing development of immunotherapies, including chimeric antigen receptor (CAR) T cells, has revolutionized cancer treatment. In pediatric relapsed/refractory B-lineage acute leukemia antiCD19-CAR induce impressive initial response rates, with event-free survival plateauing at 30-50% according to long-term follow-up data. During the interval between diagnosis of relapse or refractoriness and CAR T-cell infusion, patients require a bridging therapy. To date, this therapy has consisted of highly variable approaches based on local experience. Here, in an European collaborative effort of pediatric and adult hematologists, we summarize current knowledge with the aim of establishing guidance for bridging therapy. We discuss treatment strategies for different subgroups of patients, the advantages and disadvantages of low- and high-intensity regimens, and the potential impact of bridging therapy on outcomes after CAR T-cell infusion. This guidance is a step towards cross-institutional harmonization of bridging therapy, including personalized approaches. This will allow better comparability of clinical data and increase the level of evidence for the treatment of children and young adults with relapsed/ refractory B-lineage acute leukemia until they can receive CAR T-cell infusion.show moreshow less

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Metadaten
Author:Tobias Feuchtinger, Peter Bader, Marion Subklewe, Maike Breidenbach, Semjon Willier, Markus Metzler, Nicola Gökbuget, Julia Hauer, Fabian Müller, Paul-Gerhardt Schlegel, Michael C. FrühwaldORCiDGND, Christoph Schmid, Anja Troeger, Claudia Baldus, Roland Meisel, Annette Künkele, Max Topp, Jean-Pierre Bourquin, Gunnar Cario, Arend Von Stackelberg, Christina Peters
URN:urn:nbn:de:bvb:384-opus4-1134490
Frontdoor URLhttps://opus.bibliothek.uni-augsburg.de/opus4/113449
ISSN:1592-8721OPAC
ISSN:0390-6078OPAC
Parent Title (English):Haematologica
Publisher:Ferrata Storti Foundation (Haematologica)
Type:Article
Language:English
Year of first Publication:2024
Publishing Institution:Universität Augsburg
Release Date:2024/06/20
Volume:109
Issue:12
First Page:3892
Last Page:3903
DOI:https://doi.org/10.3324/haematol.2023.283780
Institutes:Medizinische Fakultät
Medizinische Fakultät / Universitätsklinikum
Medizinische Fakultät / Lehrstuhl für Kinder- und Jugendmedizin
Medizinische Fakultät / Professur für Transplantation und Zelltherapieforschung
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):CC-BY-NC 4.0: Creative Commons: Namensnennung - Nicht kommerziell (mit Print on Demand)