A Mathematical Description of Bone Marrow Dynamics of CAR-T Cell Therapy.

Resumen

Despite the recent success of CAR-T cell therapy in B-cell malignancies, a fraction of patients still relapse. Relapses are often preceded by recovery of healthy B cells, which suggests loss of the CAR-T cells in bone marrow, where B cells are produced. This anatomic site is harder to access and thus not as monitored as peripheral blood. Understanding the interplay between B cells, cancer cells and CAR-T cells in the bone marrow is paramount to ascertain causes for the lack of response. We present a mathematical model describing the interaction between constantly renewing B cells, CAR-T cells and leukemic cells in the bone marrow. We perform numerical simulations to understand the influence of parameters in therapy outcome, and conclude the importance of CAR-T product attributes in determining response.