Chimeric Antigen Receptor T Cells against CD19 for Multiple Myeloma.
A patient with refractory multiple myeloma received an infusion of CTL019 cells, a cellular therapy consisting of autologous T cells transduced with an anti-CD19 chimeric antigen receptor, after myeloablative chemotherapy (melphalan, 140 mg per square meter of body-surface area) and autologous stem-cell transplantation. Four years earlier, autologous transplantation with a higher melphalan dose (200 mg per square meter) had induced only a partial, transient response. Autologous transplantation followed by treatment with CTL019 cells led to a complete response with no evidence of progression and no measurable serum or urine monoclonal protein at the most recent evaluation, 12 months after treatment. This response was achieved despite the absence of CD19 expression in 99.95% of the patient's neoplastic plasma cells. (Funded by Novartis and others; ClinicalTrials.gov number, NCT02135406.).
From the Division of Hematology-Oncology, Department of Medicine (A.L.G., M.V.M., D.T.V., A.D.C., B.M.W., E.A.S.), Department of Biostatistics and Epidemiology (W.-T.H.), Department of Pathology and Laboratory Medicine (S.F.L., Y.D.M., J.J.M., Z.Z., A.B., B.L.L., C.H.J.), and Abramson Cancer Center (A.L.G., M.V.M., W.-T.H., S.F.L., Y.D.M., J.J.M., Z.Z., D.T.V., A.D.C., B.M.W., K.D., N.D.S.K., A.B., B.L.L., C.H.J., E.A.S.), Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Alfred L
AL
Garfall
Marcela V
MV
Maus
Wei-Ting
WT
Hwang
Simon F
SF
Lacey
Yolanda D
YD
Mahnke
J Joseph
JJ
Melenhorst
Zhaohui
Z
Zheng
Dan T
DT
Vogl
Adam D
AD
Cohen
Brendan M
BM
Weiss
Karen
K
Dengel
Naseem D S
ND
Kerr
Adam
A
Bagg
Bruce L
BL
Levine
Carl H
CH
June
Edward A
EA
Stadtmauer
D000328:Adult; D018941:Antigens, CD19 / Q000378:metabolism*; D001853:Bone Marrow / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D011948:Receptors, Antigen, T-Cell / Q000627:therapeutic use*; D012074:Remission Induction; D014182:Transplantation, Autologous
D018941:Antigens, CD19; C000598123:CTL019 chimeric antigen receptor; D011948:Receptors, Antigen, T-Cell