Previous allogeneic donor–derived CD19-targeted CAR T-cell therapy

Certain patients may not be amenable to producing autologous CD19-directed CAR T cells, such as those with very early relapse after HSCT. CAR T-cell therapy using cells produced from the donor of a given patient who is post-HSCT may be an option for these patients. A small group of patients who relapsed after HSCT received allogeneic CD19-directed CAR T cells that were produced from T cells obtained from donors.[200] All 13 patients obtained an MRD-negative bone marrow CR, with 83% CR at extramedullary sites. Three patients underwent a subsequent HSCT. At a median follow-up of 12 months, eight patients remained in bone marrow CR. There was only one case of acute GVHD. These results provide preliminary evidence for the safety and efficacy of using CAR T cells produced from their previous allogeneic donor in the setting of relapsed ALL.