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Case Reports
. 2017 Jan 25;9(374):eaaj2013.
doi: 10.1126/scitranslmed.aaj2013.

Molecular Remission of Infant B-ALL After Infusion of Universal TALEN Gene-Edited CAR T Cells

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Case Reports

Molecular Remission of Infant B-ALL After Infusion of Universal TALEN Gene-Edited CAR T Cells

Waseem Qasim et al. Sci Transl Med. .

Abstract

Autologous T cells engineered to express chimeric antigen receptor against the B cell antigen CD19 (CAR19) are achieving marked leukemic remissions in early-phase trials but can be difficult to manufacture, especially in infants or heavily treated patients. We generated universal CAR19 (UCART19) T cells by lentiviral transduction of non-human leukocyte antigen-matched donor cells and simultaneous transcription activator-like effector nuclease (TALEN)-mediated gene editing of T cell receptor α chain and CD52 gene loci. Two infants with relapsed refractory CD19+ B cell acute lymphoblastic leukemia received lymphodepleting chemotherapy and anti-CD52 serotherapy, followed by a single-dose infusion of UCART19 cells. Molecular remissions were achieved within 28 days in both infants, and UCART19 cells persisted until conditioning ahead of successful allogeneic stem cell transplantation. This bridge-to-transplantation strategy demonstrates the therapeutic potential of gene-editing technology.

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