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What is the Role of Hematopoietic Cell Transplantation (HCT) for Pediatric Acute Lymphoblastic Leukemia (ALL) in the Age of Chimeric Antigen Receptor T-Cell (CART) Therapy? J Pediatr Hematol Oncol 2019 07;41(5):337-344

Date

04/12/2019

Pubmed ID

30973486

DOI

10.1097/MPH.0000000000001479

Scopus ID

2-s2.0-85064242570   6 Citations

Abstract

CD19 chimeric antigen receptor T-cell (CART) therapy has revolutionized the treatment of patients with relapsed/refractory hematologic malignancies, especially B-cell acute lymphoblastic leukemia. As CART immunotherapy expands from clinical trials to FDA-approved treatments, a consensus among oncologists and hematopoietic cell transplant (HCT) physicians is needed to identify which patients may benefit from consolidative HCT post-CART therapy. Here, we review CD19 CART therapy and the outcomes of published clinical trials, highlighting the use of post-CART HCT and the pattern of relapse after CD19 CART. At this time, the limited available long-term data from clinical trials precludes us from making definitive HCT recommendations. However, based on currently available data, we propose that consolidative HCT post-CART therapy be considered for all HCT-eligible patients and especially for pediatric patients with KMT2A-rearranged B-cell acute lymphoblastic leukemia.

Author List

Taraseviciute A, Broglie L, Phelan R, Bhatt NS, Becktell K, Burke MJ

Authors

Kerri Becktell MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Larisa Broglie MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Michael James Burke MD Professor in the Pediatrics department at Medical College of Wisconsin
Rachel A. Phelan MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Antigens, CD19
Child
Gene Rearrangement
Hematopoietic Stem Cell Transplantation
Histone-Lysine N-Methyltransferase
Humans
Immunotherapy, Adoptive
Myeloid-Lymphoid Leukemia Protein
Precursor B-Cell Lymphoblastic Leukemia-Lymphoma
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Receptors, Antigen, T-Cell
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a