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Cart 19/22 T Cells

This article explores the use of CART 19/22 T Cells in clinical trials for treating refractory/relapsed acute lymphoblastic leukemia (ALL) in children, adolescents, and young adults. The trials aim to evaluate the safety and feasibility of this innovative therapy for patients who have not responded to conventional treatments. The study focuses on two types of CAR T-cell therapies: autologous CART-19/22 for B-cell ALL and allogeneic CART-NKG2D for T-cell ALL.

Table of Contents

What is CART 19/22 T Cells?

CART 19/22 T Cells is an innovative form of cell therapy being studied for the treatment of refractory or relapsed acute lymphoblastic leukemia (ALL) in children, adolescents, and young adults[1]. This therapy is a type of CAR T-cell therapy, which stands for Chimeric Antigen Receptor T-cell therapy. It’s a personalized treatment that uses a patient’s own immune cells to fight cancer.

How It Works

CART 19/22 T Cells are designed to target two specific proteins found on the surface of leukemia cells: CD19 and CD22[1]. Here’s a simplified explanation of how it works:

  1. T cells (a type of immune cell) are collected from the patient’s blood.
  2. These T cells are genetically modified in a laboratory to produce special receptors on their surface called chimeric antigen receptors (CARs).
  3. The modified T cells are then multiplied in the lab.
  4. The patient receives the modified T cells back through an intravenous (IV) infusion.
  5. Once in the body, these CART 19/22 T cells can recognize and attack cancer cells that have CD19 and/or CD22 on their surface.

Target Patients

This therapy is being studied for patients who meet the following criteria[1]:

  • Children, adolescents, and young adults (under 30 years old at diagnosis or relapse)
  • Diagnosed with B-cell acute lymphoblastic leukemia (B-ALL) that is CD19+ and/or CD22+
  • Have relapsed (cancer has returned) or refractory (cancer is not responding to standard treatments) disease
  • No other curative therapy options available

It’s important to note that this treatment is still in the research phase and is not yet widely available outside of clinical trials.

Treatment Process

The treatment process for CART 19/22 T cells involves several steps[1]:

  1. Preparation: Patients undergo tests to ensure they’re eligible for the treatment.
  2. Cell Collection: T cells are collected from the patient’s blood through a process called leukapheresis.
  3. Cell Modification: The collected T cells are sent to a laboratory where they are genetically modified and multiplied.
  4. Conditioning Chemotherapy: Patients may receive chemotherapy to prepare their body for the CAR T-cell infusion.
  5. Infusion: The modified CART 19/22 T cells are given back to the patient through an IV infusion. This is typically done in two doses, separated by 72 hours.
  6. Monitoring: Patients are closely monitored for several weeks after the infusion for potential side effects and to assess the treatment’s effectiveness.

Potential Benefits

CART 19/22 T cell therapy offers several potential benefits for patients with refractory or relapsed ALL[1]:

  • It provides a treatment option for patients who have exhausted other therapies.
  • By targeting both CD19 and CD22, it may be effective against a broader range of leukemia cells, including those that have lost CD19 expression.
  • It’s a personalized therapy using the patient’s own immune cells, potentially reducing the risk of rejection.
  • It may lead to long-lasting remissions in some patients.

Safety Considerations

While CART 19/22 T cell therapy shows promise, it’s important to be aware of potential side effects[1]:

  • Cytokine Release Syndrome (CRS): This is a common side effect that can cause fever, low blood pressure, and difficulty breathing. It’s usually manageable but can be severe in some cases.
  • Neurological Effects: Some patients may experience confusion, seizures, or other neurological symptoms.
  • B-cell Aplasia: The therapy may also destroy healthy B cells, leading to a weakened immune system.

Patients are closely monitored for these and other side effects during and after treatment.

Ongoing Research

CART 19/22 T cell therapy is currently being studied in clinical trials to assess its safety and effectiveness[2]. Researchers are looking at various aspects, including:

  • How long the modified T cells persist in the patient’s body
  • The overall response rate to the treatment
  • The therapy’s impact on patients’ quality of life
  • Potential improvements to the treatment process

As research continues, we may gain a better understanding of how to optimize this therapy and identify which patients are most likely to benefit from it.

Aspect Details
Study Type Phase I, open-label, prospective, single-center, two-armed, non-randomized trial
Target Population Children, adolescents, and young adults (< 30 years) with refractory/relapsed acute lymphoblastic leukemia
Treatment Arms Arm A: Autologous CART-19/22 for B-ALL
Arm B: Allogeneic CART-NKG2D for T-ALL
Primary Objectives Safety and feasibility of CART cell therapies
Secondary Objectives Expression of target proteins, CAR T-cell persistence, cytokine profiles, overall response rates
Key Inclusion Criteria Age < 30 years, adequate organ function, refractory/relapsed ALL not responding to conventional chemotherapy
Key Exclusion Criteria Active infections, significant cardiac issues, CNS-3 disease, uncontrolled seizures, pregnancy
Administration Intravenous infusion of CAR T cells over multiple days

FAQ

  • What is CART 19/22 T Cell therapy? CART 19/22 T Cell therapy is a type of immunotherapy that uses modified T cells to target and fight cancer cells. In this case, the T cells are engineered to recognize CD19 and CD22 proteins, which are commonly found on the surface of leukemia cells in B-cell ALL.
  • Who is eligible for this clinical trial? The trial is open to patients under 30 years old at diagnosis or relapse, with refractory or relapsed acute lymphoblastic leukemia that has not responded to conventional chemotherapy. Patients must have adequate organ function and meet specific blood count criteria.
  • What are the two arms of the clinical trial? The trial has two arms: Arm A is for patients with CD19+/- CD22+ B-ALL, who will receive autologous CART 19/22 cells. Arm B is for patients with T-ALL, who will receive allogeneic CART-NKG2D cells from a suitable haploidentical donor.
  • How is the CART 19/22 T Cell therapy administered? For Arm A, patients receive an intravenous infusion of dual autologous CART 19/22 cells over two days (days 0 and 3), separated by 72 hours if no significant side effects occur. For Arm B, patients receive an intravenous infusion of allogeneic CART-NKG2D cells divided into three daily doses (days 0, 2, and 4).
  • What are the main objectives of this clinical trial? The main objectives are to determine the safety and feasibility of autologous CART-19/22 in B-ALL patients and allogeneic CART-NKG2D T cells in T-ALL patients. Secondary objectives include studying the persistence of CAR T cells in patients' samples, evaluating cytokine profiles, and assessing overall response rates.

Ongoing Clinical Trials on Cart 19/22 T Cells

  • Study on CART 19/22 T Cells and CART45RA-NKG2D Cells for Treating Refractory/Relapsed Acute Lymphoblastic Leukemia in Children, Adolescents, and Young Adults

    Recruiting

    1 1 1
    Investigated drugs:
    Spain

  • Study on the Safety and Feasibility of CART 19/22 T Cells and CART45RA-NKG2D Cells for Children, Adolescents, and Young Adults with Acute Lymphoblastic Leukemia

    Not yet recruiting

    1 1 1
    Investigated drugs:
    Spain

Glossary

  • Acute Lymphoblastic Leukemia (ALL): A type of cancer that affects the blood and bone marrow, causing the rapid production of immature white blood cells called lymphoblasts.
  • CAR T-cell therapy: A type of immunotherapy where T cells (a type of immune cell) are genetically modified to express a chimeric antigen receptor (CAR) that targets specific proteins on cancer cells.
  • Autologous: Using cells or tissues obtained from the same individual. In this context, it refers to using the patient's own T cells to create the CAR T-cell therapy.
  • Allogeneic: Using cells or tissues obtained from a genetically similar but not identical donor. In this trial, it refers to using T cells from a haploidentical donor for the CART-NKG2D therapy.
  • Haploidentical donor: A donor who is a partial genetic match to the patient, typically a family member who shares half of the patient's human leukocyte antigens (HLAs).
  • Refractory: Resistant to treatment; in this case, it refers to leukemia that does not respond to standard therapies.
  • Relapsed: The return of a disease or symptoms after a period of improvement or remission.
  • CD19 and CD22: Proteins found on the surface of B cells, including some types of leukemia cells, which are targeted by the CART 19/22 T cells.
  • NKG2D: A receptor found on natural killer cells and some T cells, which is used in the CART-NKG2D therapy to target T-cell ALL.
  • Cytokine Release Syndrome (CRS): A potential side effect of CAR T-cell therapy, characterized by a rapid and excessive release of inflammatory molecules that can cause fever, low blood pressure, and other symptoms.

References

  1. http://clinicaltrials.eu/trial/study-on-the-safety-and-feasibility-of-cart-19-22-t-cells-and-cart45ra-nkg2d-cells-for-children-adolescents-and-young-adults-with-acute-lymphoblastic-leukemia/
  2. http://clinicaltrials.eu/trial/study-on-cart-19-22-t-cells-and-cart45ra-nkg2d-cells-for-treating-refractory-relapsed-acute-lymphoblastic-leukemia-in-children-adolescents-and-young-adults/