Secondary haematological dysplasia after CAR-T-cell therapy for acute lymphoblastic leukaemia in children.

Autor: Theron A; Leukemia and Lymphoma Department, CAR-T-Cell Unit, Pediatric Cancer Center Barcelona (PCCB), Hospital Sant Joan de Déu de Barcelona, University of Barcelona, Esplugues de Llobregat, Spain.; Department of Pediatric Oncology and Hematology, Hôpital Arnaud de Villeneuve, Univ Montpellier, CHU Montpellier, Montpellier, France., Alonso-Saladrigues A; Leukemia and Lymphoma Department, CAR-T-Cell Unit, Pediatric Cancer Center Barcelona (PCCB), Hospital Sant Joan de Déu de Barcelona, University of Barcelona, Esplugues de Llobregat, Spain.; Faculty of Medicine PhD Student, University of Barcelona, Barcelona, Spain.; Developmental Tumors Biology Group, Leukemia, and Other Pediatric Hemopathies, Pediatric Cancer Center Barcelona (PCCB), Institut de Recerca Hospital Sant Joan de Déu, Barcelona, Spain., Dapena JL; Leukemia and Lymphoma Department, CAR-T-Cell Unit, Pediatric Cancer Center Barcelona (PCCB), Hospital Sant Joan de Déu de Barcelona, University of Barcelona, Esplugues de Llobregat, Spain.; Developmental Tumors Biology Group, Leukemia, and Other Pediatric Hemopathies, Pediatric Cancer Center Barcelona (PCCB), Institut de Recerca Hospital Sant Joan de Déu, Barcelona, Spain., López-Duarte M; Pediatric Hematology Unit, Hematology Department, Hospital de Valdecilla, Santander, Spain., Diaz de Heredia C; Pediatric Hematology and Oncology Department, Hospital Universitari Vall d'Hebron, and Vall d'Hebron Institut of Research (VHIR), Barcelona, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain., Verdú-Amorós J; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.; Department of Pediatric Hematology and Oncology, Hospital Clínico Universitario, Biomedical Research Institute (INCLIVA), Valencia, Spain., Sarrate E; Hematology Laboratory, Hospital Sant Joan de Déu de Barcelona, Esplugues de Llobregat, Spain., Esperanza-Cebollada E; Developmental Tumors Biology Group, Leukemia, and Other Pediatric Hemopathies, Pediatric Cancer Center Barcelona (PCCB), Institut de Recerca Hospital Sant Joan de Déu, Barcelona, Spain., Cuatrecasas E; Cytogenetics Laboratory, Genetics Medicine Section, Hospital Sant Joan de Déu de Barcelona, Esplugues de Llobregat, Spain., Andreu S; Cytogenetics Laboratory, Genetics Medicine Section, Hospital Sant Joan de Déu de Barcelona, Esplugues de Llobregat, Spain., Conde N; Leukemia and Lymphoma Department, CAR-T-Cell Unit, Pediatric Cancer Center Barcelona (PCCB), Hospital Sant Joan de Déu de Barcelona, University of Barcelona, Esplugues de Llobregat, Spain., Sanchez-Sierra N; Leukemia and Lymphoma Department, CAR-T-Cell Unit, Pediatric Cancer Center Barcelona (PCCB), Hospital Sant Joan de Déu de Barcelona, University of Barcelona, Esplugues de Llobregat, Spain., Isola I; Developmental Tumors Biology Group, Leukemia, and Other Pediatric Hemopathies, Pediatric Cancer Center Barcelona (PCCB), Institut de Recerca Hospital Sant Joan de Déu, Barcelona, Spain.; Hematology Laboratory, Hospital Sant Joan de Déu de Barcelona, Esplugues de Llobregat, Spain., Camós M; Developmental Tumors Biology Group, Leukemia, and Other Pediatric Hemopathies, Pediatric Cancer Center Barcelona (PCCB), Institut de Recerca Hospital Sant Joan de Déu, Barcelona, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.; Hematology Laboratory, Hospital Sant Joan de Déu de Barcelona, Esplugues de Llobregat, Spain., Torrebadell M; Developmental Tumors Biology Group, Leukemia, and Other Pediatric Hemopathies, Pediatric Cancer Center Barcelona (PCCB), Institut de Recerca Hospital Sant Joan de Déu, Barcelona, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.; Hematology Laboratory, Hospital Sant Joan de Déu de Barcelona, Esplugues de Llobregat, Spain., Rives S; Leukemia and Lymphoma Department, CAR-T-Cell Unit, Pediatric Cancer Center Barcelona (PCCB), Hospital Sant Joan de Déu de Barcelona, University of Barcelona, Esplugues de Llobregat, Spain.; Developmental Tumors Biology Group, Leukemia, and Other Pediatric Hemopathies, Pediatric Cancer Center Barcelona (PCCB), Institut de Recerca Hospital Sant Joan de Déu, Barcelona, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain., Català A; Leukemia and Lymphoma Department, CAR-T-Cell Unit, Pediatric Cancer Center Barcelona (PCCB), Hospital Sant Joan de Déu de Barcelona, University of Barcelona, Esplugues de Llobregat, Spain.; Developmental Tumors Biology Group, Leukemia, and Other Pediatric Hemopathies, Pediatric Cancer Center Barcelona (PCCB), Institut de Recerca Hospital Sant Joan de Déu, Barcelona, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2024 Oct 28. Date of Electronic Publication: 2024 Oct 28.
DOI: 10.1111/bjh.19862
Abstrakt: The use of CAR-T is becoming more widespread in the treatment of haematological malignancies. In adults, secondary myelodysplastic syndromes (MDS) after CAR-T have been described. However, there are currently no data on the risk of MDS following CAR-T in children treated for acute lymphoblastic leukaemia (ALL). We studied all children treated with CAR-T cells at Hospital Sant Joan de Déu in Barcelona and those with persistent cytopenias were evaluated at the cytological, cytogenetic, and molecular levels to look for MDS. A total of 106 patients received CAR-T for ALL. Among 40 patients without early relapse or subsequent therapy after CAR-T, four fulfilled the WHO criteria for myelodysplasia. These four patients had received a haematopoietic stem cell transplantation (HSCT) prior to CAR-T and presented cytopenias with severe dysplastic changes in bone marrow after CAR-T. One patient had clonal MDS with high-risk cytogenetics arising from the host cells requiring a HSCT. Three patients had non-progressive dysplasia arising from the donor cells. Two are alive in complete remission with stable cytopenias and one succumbed to ALL relapse. This is the first description of post-CAR-T MDS and haematological dysplasia in children and highlights the need to monitor children with persistent post-CAR-T cytopenias.
(© 2024 British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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