Matched donor allogeneic CAR-T for adult B-ALL: toxicity, efficacy, repeat dosing, and the importance of lymphodepletion.

Journal: Blood

This study developed an allogeneic matched donor CD19 CAR product (CAR-DLI) for adult patients with B-cell acute lymphoblastic leukemia (B-ALL) who relapsed after allogeneic stem-cell transplantation.

Fourteen patients received CAR-DLI infusions, either alone or following lymphodepleting chemotherapy (LD) with fludarabine and cyclophosphamide.

The combination of CAR-DLI with LD significantly improved:

  • CAR-DLI engraftment, expansion, and persistence
  • 12-month event-free survival
  • Overall survival

These benefits were observed compared to CAR-DLI alone, without increasing immunotoxicity or causing significant graft-versus-host disease.

Repeat CAR-DLI dosing after relapse showed minimal benefit.

Overall, CAR-DLI with lymphodepletion demonstrated a favorable safety profile and superior efficacy in this high-risk patient population.

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