Tisagenlecleucel for the treatment of B-cell acute lymphoblastic leukemia.
Allison Barz LeahyCaitlin W ElgartenStephan A GruppShannon L MaudeDavid T TeacheyPublished in: Expert review of anticancer therapy (2019)
Cure rates for pediatric and young adult patients with refractory or recurrently relapsed acute lymphoblastic leukemia (ALL) are dismal. Survival from time of relapse is typically measured in weeks to months, and standard chemotherapy and currently approved targeted therapy achieve remission in less than a third of affected patients. To date, the only definitive curative therapy has been allogeneic hematopoietic stem cell transplant (HSCT). Advances in immunotherapy, with the introduction of chimeric antigen receptor T-cell therapies and the development of tisagenlecleucel, have changed the landscape. Areas covered: This review will describe the pharmacology of tisagenlecleucel and summarize the clinical evidence for its use in the treatment of multiple-relapsed or refractory B-cell ALL (B-ALL). Also discussed are other immunotherapies for B-ALL as well as the most commonly-encountered toxicities and corresponding management strategies. Expert commentary: Early phase trials indicate that tisagenlecleucel significantly improves survival for patients with B-ALL that is refractory or in second or later relapse. In responding patients, remissions have been reported on the order of years, and thus, tisagenlecleucel may herald a dramatic shift in the treatment paradigm of this largely fatal disease.
Keyphrases
- acute lymphoblastic leukemia
- hematopoietic stem cell
- end stage renal disease
- newly diagnosed
- ejection fraction
- prognostic factors
- chronic kidney disease
- acute myeloid leukemia
- free survival
- allogeneic hematopoietic stem cell transplantation
- peritoneal dialysis
- squamous cell carcinoma
- stem cell transplantation
- stem cells
- patient reported outcomes
- rheumatoid arthritis
- radiation therapy
- young adults
- mesenchymal stem cells
- middle aged
- gestational age