B-cell Depletion and Remissions of Malignancy Along with Cytokine-associated Toxicity in a Clinical Trial of Anti-CD19 Chimeric-antigen-receptor-transduced T Cells

Overview

Journal Blood

Publisher Elsevier

Specialty Hematology

Date 2011 Dec 14

PMID 22160384

Citations 806

Authors

James N Kochenderfer

Mark E Dudley

Steven A Feldman

Wyndham H Wilson

David E Spaner

Irina Maric

Maryalice Stetler-Stevenson

Giao Q Phan

Marybeth S Hughes

Richard M Sherry

James C Yang

Udai S Kammula

Laura Devillier

Robert Carpenter

Debbie-Ann N Nathan

Richard A Morgan

Carolyn Laurencot

Steven A Rosenberg

Affiliations

Soon will be listed here.

Abstract

We conducted a clinical trial to assess adoptive transfer of T cells genetically modified to express an anti-CD19 chimeric Ag receptor (CAR). Our clinical protocol consisted of chemotherapy followed by an infusion of anti-CD19-CAR-transduced T cells and a course of IL-2. Six of the 8 patients treated on our protocol obtained remissions of their advanced, progressive B-cell malignancies. Four of the 8 patients treated on the protocol had long-term depletion of normal polyclonal CD19(+) B-lineage cells. Cells containing the anti-CD19 CAR gene were detected in the blood of all patients. Four of the 8 treated patients had prominent elevations in serum levels of the inflammatory cytokines IFNγ and TNF. The severity of acute toxicities experienced by the patients correlated with serum IFNγ and TNF levels. The infused anti-CD19-CAR-transduced T cells were a possible source of these inflammatory cytokines because we demonstrated peripheral blood T cells that produced TNF and IFNγ ex vivo in a CD19-specific manner after anti-CD19-CAR-transduced T-cell infusions. Anti-CD19-CAR-transduced T cells have great promise to improve the treatment of B-cell malignancies because of a potent ability to eradicate CD19(+) cells in vivo; however, reversible cytokine-associated toxicities occurred after CAR-transduced T-cell infusions.

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