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供者CD19 CAR-T细胞治疗急性B淋巴细胞白血病移植后复发九例临床观察
OBJECTIVE: To investigate the long term efficacy and side effects of a donor-derived CD19 chimeric antigen receptor(CAR)T-cell(HI19α-4-1BB-ζ CAR-T)therapy in the treatment of patients with relapsed B-cell acute lymphoblastic leukemia(B-ALL)after allogeneic hematopoietic stem cell transplantation(all...
Formato: | Online Artículo Texto |
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Lenguaje: | English |
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Editorial office of Chinese Journal of Hematology
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293002/ https://www.ncbi.nlm.nih.gov/pubmed/34218580 http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2021.05.006 |
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collection | PubMed |
description | OBJECTIVE: To investigate the long term efficacy and side effects of a donor-derived CD19 chimeric antigen receptor(CAR)T-cell(HI19α-4-1BB-ζ CAR-T)therapy in the treatment of patients with relapsed B-cell acute lymphoblastic leukemia(B-ALL)after allogeneic hematopoietic stem cell transplantation(allo-HSCT). METHODS: A total of 9 subjects with relapsed B-ALL post allo-HSCT received donor-derived CD19 CAR-T therapy from July 2017 to May 2020. All subjects were infused with donor CD3-positive T cells after lymphodepletion chemotherapy, and a median dose of CAR-T cells was 1.79(range, 0.86–3.53)×10(6)/kg. RESULTS: ①All subjects achieved complete remission and MRD-negative at 28–42 d post CAR-T cells infusion. ②Cytokine releasing syndrome(CRS)occurrd in all subjects and was grade 3 in 2, grade 2 in 4, grade 1 in 3 cases respectively. Four subjects developed immune effector cell-associated neurotoxicity syndrome(ICANS), which was grade 2 in 1, grade 1 in 3. One subject developed grade IV acute graft-versus-host disease(GVHD), and side effects were all controllable. ③Four subjects relapsed at a median period of 8.6(4.6–19.3)months, 2 subjects died of disease progression after receiving chemotherapy and another one also died of disease progression 14 months after a second transplant, only 1 subject achieved complete remission after CD22 CAR-T cell therapy. Until last follow-up date, 6 subjects were leukemia-free and achieved complete donor chimerism. The estimated 1-year and 2-year leukemiafree survival(LFS)rate was 63.5% and 50.8%, with a median LFS of 18.1 months. ④After a median follow-up of 25.1(range, 6.9–36.7)months, the estimated 2-year and 2.5-year OS rate were 87.5% and 52.5%, respectively. CONCLUSION: The donor-derived CD19 CAR-T cell therapy obtain a high remission rate in relapsed B-ALL patients post allo-HSCT with tolerable side effects, half subjects survived more than 2 years without disease recurrence, though long-term efficacy requires further observation. |
format | Online Article Text |
id | pubmed-8293002 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Editorial office of Chinese Journal of Hematology |
record_format | MEDLINE/PubMed |
spelling | pubmed-82930022021-08-23 供者CD19 CAR-T细胞治疗急性B淋巴细胞白血病移植后复发九例临床观察 Zhonghua Xue Ye Xue Za Zhi 论著 OBJECTIVE: To investigate the long term efficacy and side effects of a donor-derived CD19 chimeric antigen receptor(CAR)T-cell(HI19α-4-1BB-ζ CAR-T)therapy in the treatment of patients with relapsed B-cell acute lymphoblastic leukemia(B-ALL)after allogeneic hematopoietic stem cell transplantation(allo-HSCT). METHODS: A total of 9 subjects with relapsed B-ALL post allo-HSCT received donor-derived CD19 CAR-T therapy from July 2017 to May 2020. All subjects were infused with donor CD3-positive T cells after lymphodepletion chemotherapy, and a median dose of CAR-T cells was 1.79(range, 0.86–3.53)×10(6)/kg. RESULTS: ①All subjects achieved complete remission and MRD-negative at 28–42 d post CAR-T cells infusion. ②Cytokine releasing syndrome(CRS)occurrd in all subjects and was grade 3 in 2, grade 2 in 4, grade 1 in 3 cases respectively. Four subjects developed immune effector cell-associated neurotoxicity syndrome(ICANS), which was grade 2 in 1, grade 1 in 3. One subject developed grade IV acute graft-versus-host disease(GVHD), and side effects were all controllable. ③Four subjects relapsed at a median period of 8.6(4.6–19.3)months, 2 subjects died of disease progression after receiving chemotherapy and another one also died of disease progression 14 months after a second transplant, only 1 subject achieved complete remission after CD22 CAR-T cell therapy. Until last follow-up date, 6 subjects were leukemia-free and achieved complete donor chimerism. The estimated 1-year and 2-year leukemiafree survival(LFS)rate was 63.5% and 50.8%, with a median LFS of 18.1 months. ④After a median follow-up of 25.1(range, 6.9–36.7)months, the estimated 2-year and 2.5-year OS rate were 87.5% and 52.5%, respectively. CONCLUSION: The donor-derived CD19 CAR-T cell therapy obtain a high remission rate in relapsed B-ALL patients post allo-HSCT with tolerable side effects, half subjects survived more than 2 years without disease recurrence, though long-term efficacy requires further observation. Editorial office of Chinese Journal of Hematology 2021-05 /pmc/articles/PMC8293002/ /pubmed/34218580 http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2021.05.006 Text en 2021年版权归中华医学会所有 https://creativecommons.org/licenses/by/3.0/This work is licensed under a Creative Commons Attribution 3.0 License. |
spellingShingle | 论著 供者CD19 CAR-T细胞治疗急性B淋巴细胞白血病移植后复发九例临床观察 |
title | 供者CD19 CAR-T细胞治疗急性B淋巴细胞白血病移植后复发九例临床观察 |
title_full | 供者CD19 CAR-T细胞治疗急性B淋巴细胞白血病移植后复发九例临床观察 |
title_fullStr | 供者CD19 CAR-T细胞治疗急性B淋巴细胞白血病移植后复发九例临床观察 |
title_full_unstemmed | 供者CD19 CAR-T细胞治疗急性B淋巴细胞白血病移植后复发九例临床观察 |
title_short | 供者CD19 CAR-T细胞治疗急性B淋巴细胞白血病移植后复发九例临床观察 |
title_sort | 供者cd19 car-t细胞治疗急性b淋巴细胞白血病移植后复发九例临床观察 |
topic | 论著 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293002/ https://www.ncbi.nlm.nih.gov/pubmed/34218580 http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2021.05.006 |
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