Chimeric antigen receptor therapy for chronic lymphocytic leukemia: what are the challenges?

Hematol Oncol Clin North Am. 2013 Apr;27(2):341-53. doi: 10.1016/j.hoc.2012.12.004.

Abstract

Chimeric antigen receptor (CAR)-modified T cells targeting CD19 expressed by normal and malignant B cells is a unique therapy for patients with chronic lymphocytic leukemia (CLL); recent results highlight the potential of this therapy for patients with relapsed CLL. Because adoptive transfer of CAR-modified T cells is a novel approach, there are issues for the medical oncologist to consider when evaluating current and future clinical trials for CLL patients. This article reviews the impact of CAR design, T-cell production, T-cell dose, conditioning regimens, and tumor burden at the time of CAR-modified T-cell infusion on the efficacy of this therapy.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Antigens, CD19 / immunology
  • Antigens, CD19 / metabolism
  • Clinical Trials as Topic
  • Humans
  • Immunotherapy, Adoptive
  • Leukemia, Lymphocytic, Chronic, B-Cell / genetics*
  • Leukemia, Lymphocytic, Chronic, B-Cell / immunology
  • Leukemia, Lymphocytic, Chronic, B-Cell / pathology
  • Leukemia, Lymphocytic, Chronic, B-Cell / therapy*
  • Receptors, Antigen / antagonists & inhibitors*
  • Receptors, Antigen / genetics*
  • Receptors, Antigen / immunology
  • Recombinant Proteins
  • T-Lymphocytes / immunology
  • T-Lymphocytes / metabolism
  • Tumor Burden

Substances

  • Antigens, CD19
  • Receptors, Antigen
  • Recombinant Proteins