Management of Recurrent Acute Lymphoblastic Leukemia With T-Cell Engagement: CAR T, BiTEs, and Beyond
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK
Authors: Park, Jae
Abstract
Immunotherapies targeting CD19 (blinatumomab) and CD22 (inotuzumab ozogamicin) have demonstrated higher complete response rates and improved survival compared with chemotherapy in relapsed/refractory acute lymphoblastic leukemia (ALL), and are now standard of care in the relapsed setting. However, most adult patients still die of ALL despite these therapies, with or without hematopoietic stem cell transplant. At the NCCN 2019 Annual Congress: Hematologic Malignancies, Dr. Jae Park summarized clinical data from key trials of novel immunotherapies in ALL and reviewed evidence-based treatment approaches for adults with relapsed/refractory B-cell ALL.
Upregulation of CD146 in Pediatric B-Cell Acute Lymphocytic Leukemia and Its Implications on Treatment Outcomes
JOURNAL OF IMMUNOLOGY RESEARCH
Authors: Zahran, Asmaa M.; El-Badawy, Omnia; Elsayh, Khalid, I; Mohamed, Wael M. Y.; Riad, Khalid F.; Abdel-Rahim, Mona H.; Rayan, Amal
Abstract
Background and Aim. We studied through flow cytometry the expression of CD146 on different T cells, and B-cell ALL blasts trying to correlate its expression with different prognostic factors of B-cell ALL and treatment outcomes. Patients and Methods. All pediatric patients with B-cell ALL were subjected to bone marrow examination and cytochemistry, flow cytometric immunophenotyping using monoclonal antibodies utilized for diagnosis of B-ALL including CD34, CD19, CD10, CD22, and intracellular IgM. The diagnosis was based on standard morphologic, cytochemical, and immunophenotypic followed by flow cytometric detection of CD146 expression on blast cells, CD4(+), and CD8(+) T cells. Results. Significant accumulations of CD146(+)CD4(+) cells, CD146(+)CD8(+) cells, CD4(+), CD8(+), and lymphocytes in patients were compared to controls, the mean percentages of CD146(+)CD4(+) cells, CD146(+)CD8(+) cells, and CD146(+) blasts were significantly higher in patients than controls, and in addition, these cells were associated with poor overall survival and disease-free survival. The median OS for patients with complete response was 22 +/- 1.633 (95%CI=18.799-25.201), while for those without complete response, it was 13 +/- 3.928 (95%CI=5.301-25.699), with log-rank=5.71, P=0.017. Conclusion. CD146 was expressed significantly in children's B-ALL and associated with poor prognostic features including poor response and treatment outcomes and could be a possible poor prognostic factor in pediatric B-cell ALL.