What was the initial clinical experience of patients undergoing chimeric antigen receptor (CAR) T-cell therapy to target CD19?

Updated: May 04, 2018
  • Author: Sameh Gaballa, MD, MS; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The first report of CAR T-cell therapy was in 2010, in a patient with advanced follicular lymphoma. Kochenderfer et al described dramatic regression of the lymphoma after infusion of CAR T-cells engineered to target CD19. [4]

Early studies of CAR T-cell therapy selected CD19 as the target antigen because it is expressed on the surface of almost all B-cell malignancies, including acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL), and many types of non-Hodgkin lymphoma (NHL), as well as normal B cell precursors. [1]  Not unexpectedly, bone marrow examination in the case reported by Kochenderfer et al showed selective elimination of B-cell precursors, and B cells remained absent from the blood for at least 39 weeks, whereas other blood cell counts recovered promptly. [4]

Although interaction of anti-CD19 CAR T-cells with normal B cells can result in B-cell aplasia, this condition is treatable with intravenous immunoglobulin (IVIG) replacement therapy.


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