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An exceptional case of durable remission achieved with reinfusion of CD19-directed CAR-T despite failure to induce B-cell aplasia and review of institutional experience with reinfusion of tisagenlecleucel
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  • Thomas Galletta,
  • Jeremy Rubinstein,
  • Christa Krupski,
  • Adam S. Nelson,
  • Ruby Khoury,
  • Christopher Dandoy,
  • Stella Davies,
  • Christine Phillips
Thomas Galletta
Cincinnati Children's Hospital Medical Center Cancer and Blood Diseases Institute

Corresponding Author:[email protected]

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Jeremy Rubinstein
Cincinnati Children's Hospital Medical Center
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Christa Krupski
University of Cincinnati Department of Pediatrics
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Adam S. Nelson
University of Cincinnati Department of Pediatrics
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Ruby Khoury
University of Cincinnati Department of Pediatrics
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Christopher Dandoy
University of Cincinnati Department of Pediatrics
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Stella Davies
University of Cincinnati Department of Pediatrics
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Christine Phillips
Cincinnati Children's Hospital Medical Center
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Abstract

CD19-directed chimeric antigen receptor T lymphocytes (CAR-T) have led to durable remissions in children with refractory and/or multiply relapsed B-lymphoblastic leukemia. For those who relapse or lose B-cell aplasia post-CAR-T, the role of CAR-T reinfusion is unclear. We report a case of durable remission with tisagenlecleucel reinfusion despite failure to achieve B-cell aplasia and compare this case to seven additional children who received multiple tisagenlecleucel infusions at our institution. Our experience suggests that reinfusion is safe and may be a definitive therapy for a small subset of patients. Reinfusion can also reintroduce remission and/or B-cell aplasia, allowing for subsequent therapies.
21 Dec 2022Submission Checks Completed
21 Dec 2022Assigned to Editor
21 Dec 2022Submitted to Pediatric Blood & Cancer
21 Dec 2022Review(s) Completed, Editorial Evaluation Pending
21 Dec 2022Reviewer(s) Assigned
28 Dec 2022Editorial Decision: Revise Major
03 Feb 2023Submission Checks Completed
03 Feb 2023Assigned to Editor
03 Feb 20231st Revision Received
03 Feb 2023Review(s) Completed, Editorial Evaluation Pending
03 Feb 2023Reviewer(s) Assigned
06 Feb 2023Editorial Decision: Accept