{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:53:44Z","timestamp":1790963624461,"version":"4.1.0"},"reference-count":33,"publisher":"American Society of Hematology","issue":"7","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,8,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>CD19-targeted chimeric antigen receptor (CAR) T-cell therapy has become a breakthrough treatment of patients with relapsed\/refractory B-cell acute lymphoblastic leukemia (B-ALL). However, despite the high initial response rate, the majority of adult patients with B-ALL progress after CD19 CAR T-cell therapy. Data on the natural history, management, and outcome of adult B-ALL progressing after CD19 CAR T cells have not been described in detail. Herein, we report comprehensive data of 38 adult patients with B-ALL who progressed after CD19 CAR T therapy at our institution. The median time to progression after CAR T-cell therapy was 5.5 months. Median survival after post\u2013CAR T progression was 7.5 months. A high disease burden at the time of CAR T-cell infusion was significantly associated with risk of post\u2013CAR T progression. Thirty patients (79%) received salvage treatment of post\u2013CAR T disease progression, and 13 patients (43%) achieved complete remission (CR), but remission duration was short. Notably, 7 (58.3%) of 12 patients achieved CR after blinatumomab and\/or inotuzumab administered following post\u2013CAR T failure. Multivariate analysis revealed that a longer remission duration from CAR T cells was associated with superior survival after progression following CAR T-cell therapy. In summary, overall prognosis of adult B-ALL patients progressing after CD19 CAR T cells was poor, although a subset of patients achieved sustained remissions to salvage treatments, including blinatumomab, inotuzumab, and reinfusion of CAR T cells. Novel therapeutic strategies are needed to reduce risk of progression after CAR T-cell therapy and improve outcomes of these patients.<\/jats:p>","DOI":"10.1182\/blood.2020009515","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T02:30:22Z","timestamp":1618453822000},"page":"531-543","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":70,"title":["Interventions and outcomes of adult patients with B-ALL progressing after CD19 chimeric antigen receptor T-cell therapy"],"prefix":"10.1182","volume":"138","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-8681","authenticated-orcid":false,"given":"Kitsada","family":"Wudhikarn","sequence":"first","affiliation":[{"name":"Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"},{"name":"Research Unit in Translational Hematology, Division of Hematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8310-6684","authenticated-orcid":false,"given":"Jessica R.","family":"Flynn","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7363-3963","authenticated-orcid":false,"given":"Isabelle","family":"Rivi\u00e8re","sequence":"additional","affiliation":[{"name":"Cell Therapy and Cell Engineering Center,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8683-8477","authenticated-orcid":false,"given":"Mithat","family":"G\u00f6nen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuyan","family":"Wang","sequence":"additional","affiliation":[{"name":"Cell Therapy and Cell Engineering Center,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Senechal","sequence":"additional","affiliation":[{"name":"Cell Therapy and Cell Engineering Center,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin J.","family":"Curran","sequence":"additional","affiliation":[{"name":"Bone Marrow Transplant Service, Department of Pediatrics,"},{"name":"Cellular Therapeutics Center,"},{"name":"Department of Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikhail","family":"Roshal","sequence":"additional","affiliation":[{"name":"Hematopathology Service, Department of Pathology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter G.","family":"Maslak","sequence":"additional","affiliation":[{"name":"Immunology Laboratory Service, Department of Laboratory Medicine, and"},{"name":"Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"},{"name":"Department of Medicine, Weill Cornell College of Medicine, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5248-9117","authenticated-orcid":false,"given":"Mark B.","family":"Geyer","sequence":"additional","affiliation":[{"name":"Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"},{"name":"Department of Medicine, Weill Cornell College of Medicine, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth F.","family":"Halton","sequence":"additional","affiliation":[{"name":"Cellular Therapeutics Center,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Diamonte","sequence":"additional","affiliation":[{"name":"Cellular Therapeutics Center,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6270-3065","authenticated-orcid":false,"given":"Marco L.","family":"Davila","sequence":"additional","affiliation":[{"name":"Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9031-8025","authenticated-orcid":false,"given":"Michel","family":"Sadelain","sequence":"additional","affiliation":[{"name":"Center for Cell Engineering, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renier J.","family":"Brentjens","sequence":"additional","affiliation":[{"name":"Immunology Laboratory Service, Department of Laboratory Medicine, and"},{"name":"Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"},{"name":"Department of Medicine, Weill Cornell College of Medicine, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2903-5130","authenticated-orcid":false,"given":"Jae H.","family":"Park","sequence":"additional","affiliation":[{"name":"Cellular 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