CAR T-Cell Therapy: Pediatric Patients With Relapsed and Refractory Acute Lymphoblastic Leukemia

Clin J Oncol Nurs. 2017 Apr 1;21(2 Suppl):22-28. doi: 10.1188/17.CJON.S2.22-28.

Abstract

Background: Immunotherapy provides a promising treatment option for children and adolescents with refractory or relapsed acute lymphoblastic leukemia (ALL). .

Objectives: This article presents a hospital's experience with providing chimeric antigen receptor (CAR) T-cell therapy, followed by a detailed discussion of the trajectory of treatment provided for pediatric patients and their families. .

Methods: Clinical experience in delivering care to pediatric patients undergoing CAR T-cell therapy is described. Care coordination, patient and family assessment and education, and post-CAR T-cell infusion monitoring are presented. .

Findings: Of 59 patients having been treated with CAR T-cell therapy at the authors' institution, 93% had a complete response at day 28. The 12-month relapse-free survival rate is 55%. A multidisciplinary team of skilled clinicians is recommended to support patient and family needs throughout screening, treatment, and follow-up while coordinating care with the referring oncologist.

Keywords: CAR T-cell therapy; CART-19; acute lymphoblastic leukemia; immunotherapy.

MeSH terms

  • Adolescent
  • Cell- and Tissue-Based Therapy*
  • Child
  • Chimera / immunology*
  • Education, Nursing, Continuing
  • Female
  • Humans
  • Immunotherapy*
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Receptors, Antigen, T-Cell / immunology
  • Receptors, Antigen, T-Cell / therapeutic use*
  • Recurrence
  • T-Lymphocytes / immunology*

Substances

  • Receptors, Antigen, T-Cell