Publication: Production and characterization of haploidentical CD19 CAR T cells: Validated to induce a continuous complete remission in a patient with relapsed refractory B-cell ALL
Issued Date
2020-01-01
Resource Type
ISSN
17437563
17437555
17437555
Other identifier(s)
2-s2.0-85091348722
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Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Asia-Pacific Journal of Clinical Oncology. (2020)
Suggested Citation
Somsak Prasongtanakij, Usanarat Anurathapan, Thitinee Vanichapol, Bunyada Jittorntrum, Korakot Atjanasuppat, Pongpak Pongpitcha, Samart Pakakasama, Duantida Songdej, Nongnuch Sirachainan, Karan Paisooksantivatana, Suparerk Borwaornpinyo, Borje S. Andersson, Suradej Hongeng Production and characterization of haploidentical CD19 CAR T cells: Validated to induce a continuous complete remission in a patient with relapsed refractory B-cell ALL. Asia-Pacific Journal of Clinical Oncology. (2020). doi:10.1111/ajco.13474 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/59279
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Title
Production and characterization of haploidentical CD19 CAR T cells: Validated to induce a continuous complete remission in a patient with relapsed refractory B-cell ALL
Abstract
© 2020 John Wiley & Sons Australia, Ltd Aims: The purpose of this study was to design and manufacture CD19 chimeric antigen receptor (CAR)-modified T cells for clinical use in Thailand, as a model for how this technology can be directly applied at individual institutions treating high-risk leukemia patients. Methods: We constructed second-generation CAR T cells expressing CD19 scFV-CD28-CD3ζ with different lengths of the spacer region: full, intermediate, and short length, by using a lentiviral vector. We wanted to determine whether the difference in length of the spacer would affect the cytotoxic potential of the CD19 CAR T cells against the leukemic cells. Results: We found that all constructs of CD19 CAR T cells exhibited a similar level of cytotoxicity against several human lymphoma and leukemia cell lines. For the clinical application, we chose the intermediate length spacer construct CD19 CAR T cells, hypothesizing that the highest transduction efficiency coupled with a slower initial proliferation in vitro might lead to effective leukemic cell kill, yet a lower probability for serious clinical side effects. We then tested the clinical efficacy of our CD19 CAR T cells in one patient with refractory/relapsed acute B-cell lymphoblastic leukemia. This patient indeed had minimal clinical side effects after the CAR T-cell infusion, and he remains in an unmaintained, ongoing complete remission 10+ months after his T-cell treatment. Conclusion: Our CD19 CAR T cells demonstrated efficacies in acute lymphoblastic B-cell leukemia, and will be used to establish an immunotherapeutic program for high-risk B-cell acute lymphoblastic leukemia in Thailand. We propose that this approach can be used as a model for how this new exciting technology can be applied directly at individual institutions that treat (a large number of) patients with high-risk leukemia.