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Review
. 2015 Jan 1;7(1):e2015001.
doi: 10.4084/MJHID.2015.001. eCollection 2015.

Modern immunotherapy of adult B-lineage acute lymphoblastic leukemia with monoclonal antibodies and chimeric antigen receptor modified T cells

Elena Maino  1 , Anna Maria Scattolin  1 , Piera Viero  1 , Rosaria Sancetta  1 , Anna Pascarella  1 , Michele Vespignani  1 , Renato Bassan  1
Affiliations
Review

Modern immunotherapy of adult B-lineage acute lymphoblastic leukemia with monoclonal antibodies and chimeric antigen receptor modified T cells

Elena Maino et al. Mediterr J Hematol Infect Dis. .

Abstract

The introduction of newer cytotoxic monoclonal antibodies and chimeric antigen receptor modified T cells is opening a new age in the management of B-lineage adult acute lymphoblastic leukemia. This therapeutic change must be very positively acknowledged because of the limits of intensive chemotherapy programs and allogeneic stem cell transplantation. In fact, with these traditional therapeutic tools the cure can be achieved in only 40-50% of the patients. The failure rates are particularly high in the elderly, in patients with post-induction persistence of minimal residual disease and especially in refractory/relapsed disease. The place of the novel immunotherapeutics in improving the outcome of adult patients with B-lineage acute lymphoblastic leukemia is reviewed.

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Figures

Figure 1
Figure 1
Overview of MoAb studies with rituximab, inotuzumab ozogamicin, andblinatumomab in frontline therapy of adult BCP ALL and Burkitt leukemia/lymphoma.
Figure 2
Figure 2
Overview of MoAb studies with rituximab, inotuzumab ozogamicin, and blinatumomab in adult R/R BCP ALL.
Figure 3
Figure 3
Production and activity of CAR T cells against CD19+ BCP ALL. A, stimulation of T cells using beads coated with CD3/CD28 MoAb’s and with IL2 support (other methods available; see original reference for details). B, transduction of T cells using a viral vector encoding for CD19-CAR (other methods available). C, design of second generation CAR T cells. D, T cell transduction, expansion and differentiation into T efefctor phenotype. E, target recognition, destruction and differentiation into T memory phenotype. (Used with permission, from Kenderian SS, Ruella M, Gill S, Kalos M. Chimeric antigen receptor T cell therapy to target hematological malignancies. Cancer Res. 2014;74:6383–6389).
Figure 4
Figure 4
Overview of ALL cell targets and mechanisms of action of rituximab/ofatumomab, inotuzumab ozogamicin, blinatumomab and CAR T cells in adult BCP ALL
See this image and copyright information in PMC

References

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