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Title : ALL relapse after anti-CD19 CAR-T cells therapy in a young patient: which therapeutic options ?
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  • Audrey Grain,
  • Jocelyn Ollier,
  • Thierry Guillaume,
  • Patrice Chevallier,
  • Baptiste Le Calvez,
  • Marion Eveillard,
  • Béatrice Clémenceau
Audrey Grain
ERL Centre de Cancerologie et d'Immunologie Nantes-Angers

Corresponding Author:[email protected]

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Jocelyn Ollier
ERL Centre de Cancerologie et d'Immunologie Nantes-Angers
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Thierry Guillaume
Centre Hospitalier Universitaire de Nantes
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Patrice Chevallier
Centre Hospitalier Universitaire de Nantes
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Baptiste Le Calvez
Centre Hospitalier Universitaire de Nantes
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Marion Eveillard
Centre Hospitalier Universitaire de Nantes
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Béatrice Clémenceau
ERL Centre de Cancerologie et d'Immunologie Nantes-Angers
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Abstract

Therapeutic options in B-acute lymphoblastic leukemia (ALL) relapses after anti-CD19 CAR-T cells are still debated. Here, we analysed leukemic cells of a young patient who had several CD19+ relapses of B-ALL after hematopoietic stem cells transplant (HSCT) and after anti-CD19 CAR-T cells (tisagenlecleucel). Extensive membrane immunophenotype revealed the appearance of new targets. Lysis sensibility analysis performed by 51Cr release and long term killing assays revealed the in vitro persistence of sensitivity to cytolytic activity of CAR-T cells. An immunosuppressive monocytic population was identified in the last relapse sample. Mechanisms leading to ALL resistance are analysed and therapeutic options are discussed.