PMID- 37154980
OWN - NLM
STAT- MEDLINE
DCOM- 20230602
LR  - 20230602
IS  - 1437-7772 (Electronic)
IS  - 1341-9625 (Linking)
VI  - 28
IP  - 6
DP  - 2023 Jun
TI  - Current status of CAR-T cell therapy for pediatric hematologic malignancies.
PG  - 729-735
LID - 10.1007/s10147-023-02346-6 [doi]
AB  - Acute lymphoblastic leukemia (ALL) is the most common cancer in the pediatric 
      population, and the long-term survival can reach 90%. However, approximately, 20% 
      of pediatric ALL patients experience relapse and require second-line 
      chemotherapy. This is frequently followed by hematopoietic stem cell 
      transplantation, which can cause long-term sequelae. Recent advances in 
      immunotherapy, such as monoclonal antibody therapy and chimeric antigen receptor 
      (CAR)-T cell therapy, have revolutionized the treatment of relapsed and 
      refractory ALL. Anti-CD19 CAR-T cells successfully eliminate B cell malignancies 
      such as ALL. Tisagenlecleucel (Kymriah((R))) is the first CAR-T cell immunotherapy 
      approved by the FDA. CAR-T cell therapy can cause specific adverse events (AEs) 
      such as cytokine release syndrome and immune effector cell-associated 
      neurotoxicity syndrome, which are defined and graded according to the consensus 
      grading system and treated with supportive therapies along with tocilizumab and 
      corticosteroids. Other AEs include prolonged bone marrow suppression and 
      hypogammaglobulinemia. Severe AEs are less common in the real-world experience 
      than in clinical trials, probably due to better management of the patient before 
      and during CAR-T cell therapy. The biggest challenge in CAR-T cell therapy 
      against ALL is relapse. A high tumor burden on infusion, early loss of B cell 
      aplasia, and minimal residual disease positivity after CAR-T cell infusion are 
      predictive of relapse. Consolidative stem cell transplantation may improve the 
      long-term outcome. The success of CD19 CAR-T cell therapy against B cell 
      malignancy prompted extensive research into the use of CAR-T cells against other 
      hematologic malignancies such as T cell leukemia or myeloid leukemia.
CI  - (c) 2023. The Author(s) under exclusive licence to Japan Society of Clinical 
      Oncology.
FAU - Hiramatsu, Hidefumi
AU  - Hiramatsu H
AUID- ORCID: 0000-0003-3136-5670
AD  - Department of Pediatrics, Graduate School of Medicine, Kyoto University, 54 
      Shogoin Kawahara-cho, Sakyo-ku, Kyoto City, Japan. hiramatu@kuhp.kyoto-u.ac.jp.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230508
PL  - Japan
TA  - Int J Clin Oncol
JT  - International journal of clinical oncology
JID - 9616295
RN  - 0 (cell-associated neurotoxicity)
RN  - 0 (Receptors, Chimeric Antigen)
SB  - IM
MH  - Humans
MH  - Child
MH  - *Receptors, Chimeric Antigen
MH  - *Hematopoietic Stem Cell Transplantation
MH  - *Hematologic Neoplasms/therapy
MH  - *Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology/therapy
MH  - Recurrence
OTO - NOTNLM
OT  - CAR-T cell therapy
OT  - Pediatric hematologic malignancies
OT  - Relapsed ALL
EDAT- 2023/05/08 13:41
MHDA- 2023/06/02 06:42
CRDT- 2023/05/08 11:17
PHST- 2023/03/09 00:00 [received]
PHST- 2023/04/18 00:00 [accepted]
PHST- 2023/06/02 06:42 [medline]
PHST- 2023/05/08 13:41 [pubmed]
PHST- 2023/05/08 11:17 [entrez]
AID - 10.1007/s10147-023-02346-6 [pii]
AID - 10.1007/s10147-023-02346-6 [doi]
PST - ppublish
SO  - Int J Clin Oncol. 2023 Jun;28(6):729-735. doi: 10.1007/s10147-023-02346-6. Epub 
      2023 May 8.