AUTHOR=Htun Kyaw Thu , Gong Qiang , Ma Le , Wang Ping , Tan Ya , Wu Guangsheng , Chen Jieping 

TITLE=Successful Treatment of Refractory and Relapsed CNS Acute Lymphoblastic Leukemia With CD-19 CAR-T Immunotherapy: A Case Report

JOURNAL=Frontiers in Oncology

VOLUME=Volume 11 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.699946

DOI=10.3389/fonc.2021.699946

ISSN=2234-943X

ABSTRACT=One important cause of treatment failure is extramedullary relapse among patients with acute lymphoblastic leukemia (ALL). This kind of infiltration is observed in the central nervous system. Chimeric antigen receptor-modified T cell therapy targeting CD-19 has shown to be a beneficial treatment approach in refractory and relapsed B cell acute lymphoblastic leukemia (r/r ALL). However, there is no much more studies reporting to treatment of refractory and relapsed B cell ALL in central nervous system.Here we reported one single case of a patient who has relapsed B cell ALL in CNS infiltration which was successfully treated by second generation, a CAR containing a co-st imulator CD28 or 4-1BB therapy. A 16- year old young adult male with refractory and relapsed B cell ALL in central infiltration was enrolled in a clinical trial. The patient got toxicity of grade 1 cytokine relapse syndrome and achieved significantly 36 months event free survival.This case of CAR-T treatment of relapsed and refractory ALL extramedullary central nervous system infiltration, successfully achieved 36 months disease-free survival. It is suggested that CD-19 CAR containing CD28 or 4-1BB costimulatory may be an effective method for clearing the infiltration of leukemia cells in the central nervous system. Its toxicity is mild and its safety is high.