Plasma microbial cell-free DNA following chimeric antigen receptor T cell therapy in pediatric patients with relapsed/refractory leukemia

Catherine Aftandilian; Xue Rachel Bito; David Berman; Amy Zhang; Radha Duttagupta; Kara L Davis

doi:10.1111/ejh.14216

Plasma microbial cell-free DNA following chimeric antigen receptor T cell therapy in pediatric patients with relapsed/refractory leukemia

Eur J Haematol. 2024 Apr 24. doi: 10.1111/ejh.14216. Online ahead of print.

Authors

Catherine Aftandilian¹, Xue Rachel Bito², David Berman³, Amy Zhang⁴, Radha Duttagupta⁵, Kara L Davis¹

Affiliations

¹ Pediatric Hematology/Oncology/Stem Cell Transplant and Regenerative Medicine, Stanford University, Palo Alto, California, USA.
² Cancer and Blood Disease Institute, Children's Hospital of Los Angeles, Los Angeles, California, USA.
³ Karius Diagnostics, Redwood, California, USA.
⁴ Department of Medicine, Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, California, USA.
⁵ Nucleix Ltd., Rehovot, Israel.

PMID: 38658354
DOI: 10.1111/ejh.14216

Abstract

Chimeric antigen receptor (CAR) T cell therapy is a promising treatment for pediatric patients with relapsed or refractory B cell acute lymphoblastic leukemia (R/R B ALL). Cytokine release syndrome (CRS) is a common toxicity after CAR T cell therapy and fever is often the first symptom. Differentiating CRS from infection after CAR T cell therapy can be challenging. Plasma microbial cell free DNA (mcfDNA) is a novel diagnostic tool which allows for qualitative and quantitative assessment of over 1000 organisms. This pilot study sought to characterize mcfDNA results in pediatric patients with R/R B ALL in the first 2 months after CAR T cell therapy.

Keywords: CAR T cell therapy; leukemia; microbial cell free DNA.

Grants and funding

Stanford Maternal and Child Health Research Institute