View the Full PDF at this link: CAR- T Cells in Chronic Lymphoid Leukemia – M-R-I Medical Research Institute Library



This peer reviewed medical journal article describes a patient with ALL, Lymphocytic Leukemia, which has become chronic, meaning “all the time”. The patient’s condition was also refractory which means “it was not responding to any other treatment”. The patient was treated with a very specific CAR-T cell therapy derived from the patients own immune system cells. Remission was ongoing when the paper was written ten months after treatment.

“We designed a lentiviral vector expressing a chimeric antigen receptor with specificity for the B-cell antigen CD19, coupled with CD137 (a costimulatory receptor in T cells [4-1BB]) and CD3-zeta (a signal-transduction component of the T-cell antigen receptor) signaling domains. A low dose (approximately 1.5×105 cells per kilogram of body weight) of autologous chimeric antigen receptor–modified T cells reinfused into a patient with refractory chronic lymphocytic leukemia (CLL) expanded to a level that was more than 1000 times as high as the initial engraftment level in vivo, with delayed development of the tumor lysis syndrome and with complete remission. Apart from the tumor lysis syndrome, the only other grade 3/4 toxic effect related to chimeric antigen receptor T cells was lymphopenia. Engineered cells persisted at high levels for 6 months in the blood and bone marrow and continued to express the chimeric antigen receptor. A specific immune response was detected in the bone marrow, accompanied by loss of normal B cells and leukemia cells that express CD19. Remission was ongoing 10 months after treatment. Hypogammaglobulinemia was an expected chronic toxic effect.”

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