%0 Journal Article
%A Leon-Triana, Odelaisy
%A Sabir, Soukaina
%A Calvo, Gabriel F.
%A Belmonte-Beitia, Juan
%A Chulian, Salvador
%A Martinez-Rubio, Alvaro
%A Rosa, Maria
%A Perez-Martinez, Antonio
%A Ramirez-Orellana, Manuel
%A Perez-Garcia, Victor M.
%T CAR T cell therapy in B-cell acute lymphoblastic leukaemia: Insights from mathematical models
%D 2021
%@ 1007-5704
%U http://hdl.handle.net/10668/18754
%X Immunotherapies use components of the patient immune system to selectively target cancer cells. The use of chimeric antigenic receptor (CAR) T cells to treat B-cell malignancies-leukaemias and lymphomas- is one of the most successful examples, with many patients experiencing long-lasting full responses to this therapy. This treatment works by extracting the patient's T cells and transducing them with the CAR, enabling them to recognize and target cells carrying the antigen CD19(+), which is expressed in these haematological cancers.Here we put forward a mathematical model describing the time response of leukaemias to the injection of CAR T cells. The model accounts for mature and progenitor B-cells, leukaemic cells, CAR T cells and side effects by including the main biological processes involved. The model explains the early post-injection dynamics of the different compartments and the fact that the number of CAR T cells injected does not critically affect the treatment outcome. An explicit formula is found that gives the maximum CAR T cell expansion in vivo and the severity of side effects. Our mathematical model captures other known features of the response to this immunotherapy. It also predicts that CD19(+) cancer relapses could be the result of competition between leukaemic and CAR T cells, analogous to predator-prey dynamics. We discuss this in the light of the available evidence and the possibility of controlling relapses by early re-challenging of the leukaemia cells with stored CAR T cells. 
%K Mathematical modelling
%K Cancer dynamics
%K Immunotherapy
%K Tumour-immune system interactions
%K Mathematical oncology
%K Life-span
%K Remissions
%~