Impact of corticosteroids on the efficacy of CD19/22 CAR-T cell therapy in pediatric patients with B-ALL: a single-center study
IntroductionCorticosteroids are used for toxicity management, raising concerns about whether they may affect the anti-leukemic effects of chimeric antigen receptor (CAR)-T cells.Methods and resultsIn this study, we retrospectively analyzed patients (fined two subgroups based on disease burden. Of th...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2024.1485402/full |
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| author | Jing Yang Jing Zhang Xinyu Wan Jiaoyang Cai Jiaoyang Cai Tianyi Wang Xiaomin Yang Wenjie Li Lixia Ding Lili Song Yan Miao Xiang Wang Yani Ma Chengjuan Luo Jingyan Tang Longjun Gu Jing Chen Jun Lu Yanjing Tang Benshang Li |
| author_facet | Jing Yang Jing Zhang Xinyu Wan Jiaoyang Cai Jiaoyang Cai Tianyi Wang Xiaomin Yang Wenjie Li Lixia Ding Lili Song Yan Miao Xiang Wang Yani Ma Chengjuan Luo Jingyan Tang Longjun Gu Jing Chen Jun Lu Yanjing Tang Benshang Li |
| author_sort | Jing Yang |
| collection | DOAJ |
| description | IntroductionCorticosteroids are used for toxicity management, raising concerns about whether they may affect the anti-leukemic effects of chimeric antigen receptor (CAR)-T cells.Methods and resultsIn this study, we retrospectively analyzed patients (fined two subgroups based on disease burden. Of the 75 cases in the low disease burden (LDB) group (MRD < 5%, no extramedullary disease), there was no significant difference between the use of steroids and event-free survival (EFS) (p = 0.21) and overall survival (OS) (p = 0.26), and the same was found for the 119 cases in the high disease burden (HDB) group. After eliminating the effect of consolidative transplantation on the prognosis, the EFS of the patients who did not use steroids was better (p = 0.037) in the LDB group, but the difference was not significant in the HDB group. The median cumulative dexamethasone-equivalent dose was 0.56 mg/kg, and the EFS and OS were similar in the different cumulative dose groups. Furthermore, there was no difference in the recovery of B cells and the expansion of CAR-T cell copies.Conclusion and discussionIn conclusion, under the guidance of current CRS prevention and control measures, the rational use of corticosteroids does not affect the clinical efficacy and overall survival of CAR-T cell therapy in patients with B-ALL and also does not affect the persistence of CAR-T cells in vivo, but the dosage threshold needs further clinical or experimental verification. |
| format | Article |
| id | doaj-art-b747a83f40884d8ba3259786fbb5ade9 |
| institution | Kabale University |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj-art-b747a83f40884d8ba3259786fbb5ade92025-01-13T17:07:11ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-01-011210.3389/fped.2024.14854021485402Impact of corticosteroids on the efficacy of CD19/22 CAR-T cell therapy in pediatric patients with B-ALL: a single-center studyJing Yang0Jing Zhang1Xinyu Wan2Jiaoyang Cai3Jiaoyang Cai4Tianyi Wang5Xiaomin Yang6Wenjie Li7Lixia Ding8Lili Song9Yan Miao10Xiang Wang11Yani Ma12Chengjuan Luo13Jingyan Tang14Longjun Gu15Jing Chen16Jun Lu17Yanjing Tang18Benshang Li19Department of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaChild Health Advocacy Institute, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Hematology/Oncology, Children’s Hospital of Soochow University, Suzhou, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cell Immunotherapy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaIntroductionCorticosteroids are used for toxicity management, raising concerns about whether they may affect the anti-leukemic effects of chimeric antigen receptor (CAR)-T cells.Methods and resultsIn this study, we retrospectively analyzed patients (fined two subgroups based on disease burden. Of the 75 cases in the low disease burden (LDB) group (MRD < 5%, no extramedullary disease), there was no significant difference between the use of steroids and event-free survival (EFS) (p = 0.21) and overall survival (OS) (p = 0.26), and the same was found for the 119 cases in the high disease burden (HDB) group. After eliminating the effect of consolidative transplantation on the prognosis, the EFS of the patients who did not use steroids was better (p = 0.037) in the LDB group, but the difference was not significant in the HDB group. The median cumulative dexamethasone-equivalent dose was 0.56 mg/kg, and the EFS and OS were similar in the different cumulative dose groups. Furthermore, there was no difference in the recovery of B cells and the expansion of CAR-T cell copies.Conclusion and discussionIn conclusion, under the guidance of current CRS prevention and control measures, the rational use of corticosteroids does not affect the clinical efficacy and overall survival of CAR-T cell therapy in patients with B-ALL and also does not affect the persistence of CAR-T cells in vivo, but the dosage threshold needs further clinical or experimental verification.https://www.frontiersin.org/articles/10.3389/fped.2024.1485402/fullleukemiaChimeric antigen receptorcytokine release syndromecorticosteroidschildren |
| spellingShingle | Jing Yang Jing Zhang Xinyu Wan Jiaoyang Cai Jiaoyang Cai Tianyi Wang Xiaomin Yang Wenjie Li Lixia Ding Lili Song Yan Miao Xiang Wang Yani Ma Chengjuan Luo Jingyan Tang Longjun Gu Jing Chen Jun Lu Yanjing Tang Benshang Li Impact of corticosteroids on the efficacy of CD19/22 CAR-T cell therapy in pediatric patients with B-ALL: a single-center study Frontiers in Pediatrics leukemia Chimeric antigen receptor cytokine release syndrome corticosteroids children |
| title | Impact of corticosteroids on the efficacy of CD19/22 CAR-T cell therapy in pediatric patients with B-ALL: a single-center study |
| title_full | Impact of corticosteroids on the efficacy of CD19/22 CAR-T cell therapy in pediatric patients with B-ALL: a single-center study |
| title_fullStr | Impact of corticosteroids on the efficacy of CD19/22 CAR-T cell therapy in pediatric patients with B-ALL: a single-center study |
| title_full_unstemmed | Impact of corticosteroids on the efficacy of CD19/22 CAR-T cell therapy in pediatric patients with B-ALL: a single-center study |
| title_short | Impact of corticosteroids on the efficacy of CD19/22 CAR-T cell therapy in pediatric patients with B-ALL: a single-center study |
| title_sort | impact of corticosteroids on the efficacy of cd19 22 car t cell therapy in pediatric patients with b all a single center study |
| topic | leukemia Chimeric antigen receptor cytokine release syndrome corticosteroids children |
| url | https://www.frontiersin.org/articles/10.3389/fped.2024.1485402/full |
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