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06-08-2018 | Guidelines | Article

Management guidelines for paediatric patients receiving chimeric antigen receptor T cell therapy

Journal:
Nature Reviews Clinical Oncology

Authors: Kris M. Mahadeo, Sajad J. Khazal, Hisham Abdel-Azim, Julie C. Fitzgerald, Agne Taraseviciute, Catherine M. Bollard, Priti Tewari, Christine Duncan, Chani Traube, David McCall, Marie E. Steiner, Ira M. Cheifetz, Leslie E. Lehmann, Rodrigo Mejia, John M. Slopis, Rajinder Bajwa, Partow Kebriaei, Paul L. Martin, Jerelyn Moffet, Jennifer McArthur, Demetrios Petropoulos, Joan O’Hanlon Curry, Sarah Featherston, Jessica Foglesong, Basirat Shoberu, Alison Gulbis, Maria E. Mireles, Lisa Hafemeister, Cathy Nguyen, Neena Kapoor, Katayoun Rezvani, Sattva S. Neelapu, Elizabeth J. Shpall, the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network

Publisher: Nature Publishing Group UK

Abstract

In 2017, an autologous chimeric antigen receptor (CAR) T cell therapy indicated for children and young adults with relapsed and/or refractory CD19+ acute lymphoblastic leukaemia became the first gene therapy to be approved in the USA. This innovative form of cellular immunotherapy has been associated with remarkable response rates but is also associated with unique and often severe toxicities, which can lead to rapid cardiorespiratory and/or neurological deterioration. Multidisciplinary medical vigilance and the requisite health-care infrastructure are imperative to ensuring optimal patient outcomes, especially as these therapies transition from research protocols to standard care. Herein, authors representing the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Hematopoietic Stem Cell Transplantation (HSCT) Subgroup and the MD Anderson Cancer Center CAR T Cell Therapy-Associated Toxicity (CARTOX) Program have collaborated to provide comprehensive consensus guidelines on the care of children receiving CAR T cell therapy.

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