Title : ALL relapse after anti-CD19 CAR-T cells therapy in a young
patient: which therapeutic options ?
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.