Who can enter
- Children and young adults up to 25 years old treated with CAR T therapy in the Princess Máxima Center
- Children that received CAR T therapy in another hospital and come to the Maxima for follow-up can also enter
- The research focuses on the first year after CAR T-cell therapy
Goal
The goal of this research is to understand why CAR T-cell therapy is highly effective in only 50% of the patients.
Background
Treatment options for relapsed and refractory B-cell leukemia in children have improved greatly since the introduction of immunotherapy. Treatment with CAR T-cells, a form of cell therapy in which the patient's own immune cells are targeted against the leukemia, has entered reimbursed care. In this form of cell therapy, the patient's immune cells are genetically altered outside the body so that they have an extra protein that can recognize and destroy the leukemia cells. To do this, the immune cells are first altered and then multiplied before being given back to the patient.
This is a new form of therapy whose long-term effects are not yet sufficiently known. We also do not yet know which patients will respond and which will not. If we understand this better, we will also be able to use the current therapy better.
In this study, we follow up children who are receiving CAR T-cell therapy. We do this by taking extra blood, bone marrow or cerebrospinal fluid several times during regular check-ups. This is not inconvenient for the children because we only do the withdrawals if blood, bone marrow or cerebrospinal fluid would also be taken for regular care. We also collect stool samples from these children.
As an additional examination, we ask if we can also take a bone biopsy (a small piece of bone) during a bone marrow puncture. The doctor will explain exactly what this means.