CAR T
Published on December 10, 2024
Hematologic dysplasia in pediatric patients following CAR T-cell therapy for ALL
by BJHaem
Theron A, Alonso-Saladrigues A, Dapena J-L, et al. Secondary Haematological Dysplasia After CAR-T-Cell Therapy for Acute Lymphoblastic Leukaemia in Children. British Journal of Haematology. 2024; (doi: 10.1111/bjh.19862).
The potential for secondary myelodyspastic syndromes (MDS) following chimeric antigen receptor (CAR) T-cell therapy in children with acute lymphoblastic leukemia (ALL) is a real concern, researchers say. They conducted a single-site study of 106 pediatric patients who underwent CAR T-cell therapy, ultimately identifying 4 patients who met the clinical definition of myelodysplasia. Each had undergone hematopoietic stem cell transplantation (HSCT) before being treated with CAR T cells, several months after which they developed cytopenias with severe dysplastic changes in bone marrow. One case reflected high-risk cytogenic abnormalities tied to the host cells requiring HSCT. The other three involved chronic, non-progressive hematological dysplasia attributed to the donor cells. A patient in one of those cases relapsed and died, while the other two are in complete remission with stable cytopenias. The study authors say their findings — the first to describe MDS and hematological dysplasia in pediatric patients following CAR-T infusion — point to the need to monitor children with persistent post-CAR-T cytopenias.
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