1830 - CART-19: a comparative between literature versus experience

Background

CART-19 therapy is an immunotherapy treatment based in extracorporeal and synthetic modification of T-lymphocytes from the patient that goes through the therapy. This therapy is used in treatment of haematological cancers like chronic lymphocytic leukaemia (CLL) and acute lymphoblastic leukaemia (ALL) and it can be administered through one aliquot or three aliquots. It is a new therapy recently introduced in cancer treatment which introduces multiple challenges like side effects management. Its main side effect is cytokine release syndrome (CRS). The aim of this study is to compare the side effects observed in patients treated with CART-19 therapy versus side effects described in the literature.

Methods

This is an observational, transversal and retrospective study based in medical records review. The patients included in this study are adults treated with CART-19 therapy in Hospital Clinic Barcelona between January 2017 and April 2019. Data analysis has been done through Excel programme and taking into account clinical variables like: age, diagnosis, arterial pressure, heart rate, number of aliquots and Intensive Care Unit (UCI) requirement.

Results

A total of 27 CART-19 therapies have been administered. 70,4% from infusions have been done in patients with a diagnosis from ALL. The main side effects that have been observed are hypotension in a 29,6%, tachycardia in 22,2% and headache in 11,1%. Fever has been observed in a 85,2% of the infusions and it has appeared in the first 24 hours post-infusion in a 63% of the cases. A high percentage of the infusions have been administered in one aliquot (70,4%). Only in an 29,8% of the cases the patient needed a transfer to an UCI and a 22,2% needed Tocilizumab administration for CRS decrease.

Conclusions

The main conclusion obtained is that observed side effects in patients that have received CART-19 therapy coincide with the ones described in literature, without any new appearance. It is important to emphasise that fever has appeared in patients independent of the number of aliquots received and clinical variables affected. On the other hand, low incidence of neurological and gastrointestinal affections has been observed.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.