ArticleBlood advances2022
Characterization of extramedullary disease in B-ALL and response to CAR T-cell therapy.
Article in Blood advances, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers.
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Who cites it
46 citing papers in PubMed, 60 citations in OpenAlex.
- High-risk features in adult patients with B-cell acute lymphoblastic leukemia: redefining risk in the era of targeted immunotherapy.Blood research · 2026Review
- The evolving landscape of CAR T cell therapy in children and young adults with B cell acute lymphoblastic leukemia.Molecular therapy. Oncology · 2026Review
- CD19/CD22 bivalent CAR T cells in children, adolescents and young adults with B-ALL: final phase 1 trial results.Journal for immunotherapy of cancer · 2026Article
- CD19 CAR T cells for B-ALL with EMD.Blood advances · 2026Article
- CD19 CAR T-cell outcomes in relapsed/refractory extramedullary B-ALL: a multisite, retrospective cohort review.Blood advances · 2026Article
- Challenges and advances in CAR-T cell therapy for B-ALL.Biomarker research · 2026Review
- CRLF2 rearrangement and extramedullary disease in B-cell acute lymphoblastic leukemia: a possible link?Blood advances · 2026Article
- Persistent Unilateral Pleural Effusion with Chimeric Antigen Receptor T-cell Infiltration in Primary Mediastinal Large B-cell Lymphoma.Internal medicine (Tokyo, Japan) · 2026Article
- The quintessential role for CAR T cell therapy in children, adolescents and young adults with cancer.Nature reviews. Clinical oncology · 2026Review
- Baseline [European journal of nuclear medicine and molecular imaging · 2026Article
- Efficacy of chimeric antigen receptor T-cell therapy in testicular relapse of pediatric acute lymphoblastic leukemia: a multicenter retrospective study.Frontiers in immunology · 2026Article
- Sanctuary sites and extramedullary relapses in the chemo-free world: insights from immunotherapies in B-ALL.Hematology. American Society of Hematology. Education Program · 2025Review
- With BiTEs at the kiddie table, where do CARs come in for pediatric B-ALL?Hematology. American Society of Hematology. Education Program · 2025Review
- Patterns of relapse in patients with multiple myeloma receiving chimeric antigen receptor T cell therapy: a multi-center analysis.Leukemia · 2025Article
- Article
- Therapies and outcomes following extramedullary relapse of pediatric and young adult ALL after CD19 CAR T-cell therapy.Blood advances · 2025Article
- Prominent efficacy and good safety of sequential CD19 and CD22 CAR-T therapy in relapsed/refractory adult B-cell acute lymphoblastic leukemia.Experimental hematology & oncology · 2025Article
- Endothelial dysfunction and hemostatic imbalance in CAR T-cell-associated toxicities: pathophysiological insights and the role of circulating biomarkers.Frontiers in immunology · 2025Review
- Evolving strategies for addressing CAR T-cell toxicities.Cancer metastasis reviews · 2024Review
- Article
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Authors and funding
14 authors at 2 institutions in 1 country.
Funding
Abstract
Chimeric antigen receptor (CAR) T cells effectively eradicate medullary B-cell acute lymphoblastic leukemia (B-ALL) and can traffic to and clear central nervous system (CNS) involvement. CAR T-cell activity in non-CNS extramedullary disease (EMD) has not been well characterized. We systematically evaluated CAR T-cell kinetics, associated toxicities, and efficacy in B-ALL non-CNS EMD. We conducted a retrospective review of B-ALL patients with non-CNS EMD who were screened for/enrolled on one of three CAR trials (CD19, CD22, and CD19/22) at our institution. Non-CNS EMD was identified according to histology or radiographic imaging at extramedullary sites excluding the cerebrospinal fluid and CNS parenchyma. Of ∼180 patients with relapsed/refractory B-ALL screened across multiple early-phase trials over an 8-year period, 38 (21.1%) presented with isolated non-CNS EMD (n = 5) or combined medullary/non-CNS EMD (n = 33) on 18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging. A subset receiving CAR T cells (18 infusions) obtained FDG PET/CT scans preinfusion and postinfusion to monitor response. At best response, 72.2% (13 of 18) of patients showed a medullary minimal residual disease-negative complete remission and complete (n = 7) or partial (n = 6) non-CNS EMD response. Non-CNS EMD responses to CAR T cells were delayed (n = 3), and residual non-CNS EMD was substantial; rarely, discrepant outcomes (marrow response without EMD response) were observed (n = 2). Unique CAR-associated toxicities at non-CNS EMD sites were seen in select patients. CAR T cells are active in B-ALL non-CNS EMD. Still, non-CNS EMD response to CAR T cells may be delayed and suboptimal, particularly with multifocal disease. Serial FDG PET/CT scans are necessary for identifying and monitoring non-CNS EMD.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.