Real-world data confirmed the efficacy and safety profiles of tisagenlecleucel among patients with relapsed/refractory (R/R) acute lymphoblastic leukemia (ALL) younger than 3 years old, according to results of a registry study presented at the 2022 American Society of Pediatric Hematology/Oncology Conference.
Previous data suggest that real-world outcomes are similar to those observed in clinical trials of tisagenlecleucel in patients with R/R ALL age 3 or older. However, children age younger than 3 years were not enrolled in the clinical trials. The aim of this study was to evaluate the real-world outcomes of this population after treatment with tisagenlecleucel.
The retrospective study evaluated data of 47 patients with R/R ALL from the CIBMTR database who received tisagenlecleucel. The median age of the cohort was 20.4 months, 51% were female, 17% had primary refractory disease, and 57.4% had relapsed disease. The majority of patients were transplant-naïve.
Leukapheresis was performed when patients were a median age of 18 months (range, 3-35 months). The chimeric antigen receptor (CAR) T-cell dose was a median of 2.4 x 106 /kg with a viability of 89.8%. Diagnosis to CAR-T infusion was a median of 251 days, and the median days from apheresis to infusion was 46.
Among patients evaluable for efficacy, there were 76.3% who achieved complete response within 100 days after infusion. The median duration of response and relapse-free survival was not reached and were 79.9% each at 3 months. The median event-free survival was 9.7 months, with a 3-month rate of 65.2%.
Cytokine release syndrome (CRS) developed among 76.3% of patients, but was primarily mild to moderate, with 7.3% of patients experience grade 3 CRS. The median time to onset was 6.5 days after infusion and lasted for a median of 6 days.
Neurotoxicity occurred among 12.2% of patients, including 7.3% who developed grade 3 severity. The median time to onset was 9 days and the median duration of neurotoxicity was 8 days. All cases of neurotoxicity resolved.
Progressive disease resulted in 2 deaths, and there were no deaths reported that were related to tisagenlecleucel treatment. The authors concluded that “registry data reveal high rates of durable response and a favorable safety profile in patients <3 years with R/R ALL treated with tisagenlecleucel.”
Disclosures: This research was supported by Novartis.
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Guest E, Moskop A, Heim M, et al. Real-world outcomes for pediatric patients aged <3 years with R/R ALL treated with tisagenlecleucel. Presented at: 2022 American Society of Pediatric Hematology/Oncology (ASPHO) Conference; May 4-7, 2022. Abstract 2010.