ACUTE LYMPHOBLASTIC LEUKEMIA
O035 - PRE-TRANSPLANT MRD NEGATIVITY PREDICTS FAVORABLE OUTCOMES OF CAR-T THERAPY FOLLOWED BY HAPLOIDENTICAL HSCT FOR RELAPSED/REFRACTORY ACUTE LYMPHOBLASTIC LEUKEMIA: A MULTI-CENTER RETROSPECTIVE STUDY
Yongxian Hu, Houli Zhao, Guoqing Wei, et al.
Conclusions: Haplo-HSCT after CAR-T treatmentcould greatly improve LFS and OS without increasing risks of treatment-relatedtoxicity.Moreover, we confirmed that achieving pre-transplantMRD negativity after CAR-T treatment is a suitable basis for haplo-HSCT.
Xian Zhang, Junfang Yang, Jianping Zhang, et al.
Conclusions: Our study demonstrates that a high CR rate can still be achieved through CAR-T therapy even for those who relapsed after allo-HSCT without increasing CRS or neurotoxicity. A second consolidation allo-HSCT may be considered for those who achieved MRD-negative CR after CAR-T. Receiving CAR-T cells that manufactured from transplant donors may result in a trend towards higher GVHD rate compared to autologous CAR-T cells. GVHD should be carefully watched and managed.
Lamis Eldjerou, Christopher Acker, Damien Howick, et al.
Conclusions: Leukapheresis and tisagenlecleucel manufacturing in pts with r/r ALL < 3 years of age and low weight are feasible and do not present manufacturability risk compared with clinical trial experience in patients ≥ 3 years of age.
Caroline Louise Furness, Rachael Hough, Michelle Cummins, et al.
Conclusions: The establishment of a national panelin England for Tisagenlecleucel approval has allowed prompt,equitable and trackable access to this CAR-T product for ALL. From a worldwideperspective, NHSE is one of the first health services to introduce a nationalco-ordinated access programme of care and will utilise programme data to assessreal world outcomes for patients treated with Tisagenlecleucel.
Valentín Ortiz-Maldonado, Anna Alonso-Saladrigues, Miguel Caballero-Baños, et al.
Conclusions: The incidence of SOS in patients with R/R B-ALL treated with ARI-0001 cells was 7.9%. However, it was 20% among those patients with both alloHCT and IO treatment. No SOS occurred in patients without prior alloHCT plus IO treatment. These results led us to incorporate liver imaging studies to our screening tests in patients with prior alloHCT/IO history who are referred for ARI-0001 cell therapy.
Felix Korell, Sascha Laier, Sandra Sauer, et al.
Conclusions: Leukapheresis was feasible in all patients in an out-patient setting. To harvest a sufficient number of lymphocytes for CART cell production, a minimum of 12 -15 L total blood volume should be processed in patients with an ANC 1-3/nl and ALC 0.3-1/nl. We established therefore a standardized procedure for the apheresis handling and developed a recommendation list for the timing of the medication before apheresis.
Ignacio Gómez-Centurión, Saskia Burridge, Juliana Silva, Arina Lazareva, et al.
Conclusions: Cytopenias were frequent in patients treated with Tisagenlecleucel. Whilst early cytopenias are expected due to lymphodepletion, mechanisms of persistent and recurrent cytopenias are unclear and might be related to CAR-T cells persistence. More studies are needed to determine etiology and risk factors for persistent cytopenias. Cytopenias are of relevance in terms of increased requirement for supportive care, however, in our cohort, were not associated with significant or persisting complications.
Francesco Paolo Tambaro, Sajad Khazal, Dristhi Ragoonanan, et al.
Conclusions: The majority of 53 reported patients with ALL and extra-medullary breast involvement (22 occurred post-SCT) received combined radiation and chemotherapy; 4 received DLI and achieved CR but 2 died of severe GvHD. CAR-T cells, may likewise circulate and act in sequestered sites but without GvHD. Lympho-depletion preceding CAR-T may also eliminate regulatory T lymphocytes and potentially enhance the immune response. Combined treatment with CAR-T and radiation may help eradicate extra-medullary disease, taking advantage of the local death of dividing cells with radiation with potential enhancement of the microenvironment to facilitate CAR-T function and enhance anti-tumor immune response of resident T cells. Future studies will elucidate the optimal timing of CART among patients with extra-medullary disease, which may improve durability of response and long-term outcomes.