Curing CLL? Long-Term CD19 CAR T-Cell Therapy Updates

If you’ve received CD19 CAR T-cell therapy, you may wonder how effective this treatment is in the long term for relapsed/refractory chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL). 

Recent research presented at the 2024 ASH conference offers valuable insights. Continue reading to learn more. 

How Effective is CD19 CAR T-Cell Therapy for CLL/SLL After Five Years?

In collaboration with the University of Pennsylvania, Benjamin F. Frost, MD, of the Brigham and Women's Hospital, led research efforts to review the long-term data of two previous clinical trials. In these studies, 57 CLL/SLL patients had received just the CD19-directed CAR T-cell therapy or in combination with ibrutinib. CD19 is a surface protein found on CLL cells, and these CAR T-cells are specially designed to target it.

Unlike commercial CAR T-cell therapies like liso-cel (Breyanzi, BMS), the researchers created and produced the CAR T-cells in these trials. 

Of these 57 patients, 31 achieved either a full or partial reduction of CLL cells (71% complete response and 29% partial) one year after the infusion. At the five-year mark since treatment, researchers found:

• Progression-free survival (PFS)
  • 57.1% of patients who received the CAR T-cell therapy alone remained progression-free—meaning the cancer cells had not grown or expanded.
  • Patients who received CAR T-cell therapy with ibrutinib had an even better outcome, with 64.7% progression-free after 5 years.
• Overall survival rates were 78.6% for those who received CAR T-cell therapy alone and 70.6% for those who combined it with ibrutinib.

Another important fact from the study was that achieving a complete response within one year of CAR-T infusion significantly improved the odds of long-term remission and survival.

Managing Long-Term Side Effects

While CAR T-cell therapy has shown promising results, most patients experienced B-cell aplasia. In this condition, CAR T-cells target healthy B-cells, causing the body to produce fewer antibodies and increase the risk of infections. To manage this, most patients required monthly immunoglobulin infusions (IVIG). 

Click here to learn more about the management strategies for CAR T-cell therapy's side effects. 

Key Takeaways

• If you remain progression-free one year after your CD19 CAR T-cell infusion, there’s a high likelihood that your CLL cells will stay low or controlled for over five years without additional treatment.
• Achieving a complete response within one year is linked to better long-term outcomes, including improved PFS and overall survival.
• Despite the initially poor prognosis of relapsed/refractory CLL patients, this study suggests that a subset of patients may achieve long-term remission or even be cured with CD19 CAR T-cell therapy.
• Ongoing research with CAR T-cell therapies is looking to expand its benefits and long-term disease control to more patients in the future.

Do you want to learn more about CLL treatments? Find answers in HealthTree’s CLL Therapy Guide below!

Access the Free CLL Therapy Guide

Source: 

• Curing CLL: Long-Term Outcomes of Chronic Lymphocytic Leukemia Patients with at Least One Year of Response to CART-19 Therapy