College
College of Arts and Sciences
Mentor Information
Olukemi Akintewe
Description
Pediatric Acute Lymphoblastic Leukemia (ALL) is a prevalent childhood malignancy; although survival for standard cases is high (85%), prognosis for relapsed or refractory disease remains poor, with survival rates at 50%. Innovations in immunotherapy, including Chimeric antigen receptor T-cell (CAR-T) therapy, address these relapse rates. CAR-T therapy harvests and modifies T-cells from the patient to target and eliminate cancer cells. This review evaluates the clinical impact of modified T-cells on treatment response, analyzes the management of associated toxicities, and identifies biological barriers to sustained remission in pediatric populations. The review was conducted using databases such as PubMed and Google Scholar to analyze clinical trial data and laboratory studies. 60 peer-reviewed articles were screened for relevance to treatment efficacy, persistence, and safety profiles across various pediatric ALL subtypes. In clinical trials, pediatric patients achieved high rates of complete remission (90%) and low rates of measurable residual disease when treated with the modified T cells. Success was due to the involvement of CD-19 domains linked to costimulatory domains that generated specific apoptosis and contributed to the resistance of immunosuppressive signaling. However, therapy is frequently complicated by significant toxicities, including Cytokine Release Syndrome and neurotoxicity. These findings conclude the potential benefits of CAR T-cell therapy, but its effectiveness is balanced against severe safety concerns and biological resistance. While responses to T-cells may be limited through antigen loss and toxicities, research including dual antigen response and regulation of antigen strength presents hopeful advances when targeting relapse in pediatric ALL.
Effects of Modified T-cells on Treatment Response of Pediatric Acute Lymphoblastic Leukemia
Pediatric Acute Lymphoblastic Leukemia (ALL) is a prevalent childhood malignancy; although survival for standard cases is high (85%), prognosis for relapsed or refractory disease remains poor, with survival rates at 50%. Innovations in immunotherapy, including Chimeric antigen receptor T-cell (CAR-T) therapy, address these relapse rates. CAR-T therapy harvests and modifies T-cells from the patient to target and eliminate cancer cells. This review evaluates the clinical impact of modified T-cells on treatment response, analyzes the management of associated toxicities, and identifies biological barriers to sustained remission in pediatric populations. The review was conducted using databases such as PubMed and Google Scholar to analyze clinical trial data and laboratory studies. 60 peer-reviewed articles were screened for relevance to treatment efficacy, persistence, and safety profiles across various pediatric ALL subtypes. In clinical trials, pediatric patients achieved high rates of complete remission (90%) and low rates of measurable residual disease when treated with the modified T cells. Success was due to the involvement of CD-19 domains linked to costimulatory domains that generated specific apoptosis and contributed to the resistance of immunosuppressive signaling. However, therapy is frequently complicated by significant toxicities, including Cytokine Release Syndrome and neurotoxicity. These findings conclude the potential benefits of CAR T-cell therapy, but its effectiveness is balanced against severe safety concerns and biological resistance. While responses to T-cells may be limited through antigen loss and toxicities, research including dual antigen response and regulation of antigen strength presents hopeful advances when targeting relapse in pediatric ALL.
