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Efficacy and Safety of Chimeric Antigen Receptor T Cells in Acute Lymphoblastic Leukemia With Post-Transplant Relapse

Twenty patients with relapsed B-ALL after HSCT were treated with CAR T cell therapy and were evaluated for efficacy and safety. Twelve patients previously received haploidentical transplantation, while 8 patients received HLA-matched transplantation. The median relapse time was 12 months (range, 4 t...

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Autores principales: Ding, Lijuan, Wang, Yiyun, Hong, Ruimin, Zhao, Houli, Zhou, Linghui, Wei, Guoqing, Wu, Wenjun, Xu, Huijun, Zhang, Yanlei, Luo, Yi, Shi, Jimin, Chang, Alex H., Hu, Yongxian, Huang, He
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591161/
https://www.ncbi.nlm.nih.gov/pubmed/34790576
http://dx.doi.org/10.3389/fonc.2021.750218
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author Ding, Lijuan
Wang, Yiyun
Hong, Ruimin
Zhao, Houli
Zhou, Linghui
Wei, Guoqing
Wu, Wenjun
Xu, Huijun
Zhang, Yanlei
Luo, Yi
Shi, Jimin
Chang, Alex H.
Hu, Yongxian
Huang, He
author_facet Ding, Lijuan
Wang, Yiyun
Hong, Ruimin
Zhao, Houli
Zhou, Linghui
Wei, Guoqing
Wu, Wenjun
Xu, Huijun
Zhang, Yanlei
Luo, Yi
Shi, Jimin
Chang, Alex H.
Hu, Yongxian
Huang, He
author_sort Ding, Lijuan
collection PubMed
description Twenty patients with relapsed B-ALL after HSCT were treated with CAR T cell therapy and were evaluated for efficacy and safety. Twelve patients previously received haploidentical transplantation, while 8 patients received HLA-matched transplantation. The median relapse time was 12 months (range, 4 to 72). Thirteen patients received autologous CAR T cells, and 7 patients received allogeneic CAR T cells, which were derived from transplant donors. The median infusion dose was 2.9×106/kg (range, 0.33 to 12×106/kg). Nineteen patients were evaluated for efficacy, among which 17 patients (89.5%) achieved MRD negative. The CR rates in the HLA-matched transplantation group and haploidentical transplantation group were 100% (7/7) and 83.3% (10/12), respectively. The median follow-up time was 9.80 months (range, 2.40 to 64.97). Ten patients (50%) died of relapse, 3 patients (15%) died of infection, and 1 patient (5%) died of aGVHD. Fifteen patients (75%) developed CRS, including 3 (20%) grade 1 CRS, 6 (40%) grade 2 CRS, and 6 (40%) grade 3 CRS. Ten patients (50%) developed aGVHD, including 1 (10%) grade I aGVHD, 6 (60%) grade II aGVHD, and 3 (30%) grade III aGVHD. The log rank test showed that CAR T cell origin was correlated with aGVHD occurrence in the haploidentical transplantation group (P = 0.005). The authors’ study indicated that the initial efficacy and safety of CAR T cell therapy for patients with post-transplant relapse were satisfactory. However, aGVHD was a concern in patients with a history of haploidentical transplantation occupied with allogeneic CAR T cells, which warrants clinical attention.
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spelling pubmed-85911612021-11-16 Efficacy and Safety of Chimeric Antigen Receptor T Cells in Acute Lymphoblastic Leukemia With Post-Transplant Relapse Ding, Lijuan Wang, Yiyun Hong, Ruimin Zhao, Houli Zhou, Linghui Wei, Guoqing Wu, Wenjun Xu, Huijun Zhang, Yanlei Luo, Yi Shi, Jimin Chang, Alex H. Hu, Yongxian Huang, He Front Oncol Oncology Twenty patients with relapsed B-ALL after HSCT were treated with CAR T cell therapy and were evaluated for efficacy and safety. Twelve patients previously received haploidentical transplantation, while 8 patients received HLA-matched transplantation. The median relapse time was 12 months (range, 4 to 72). Thirteen patients received autologous CAR T cells, and 7 patients received allogeneic CAR T cells, which were derived from transplant donors. The median infusion dose was 2.9×106/kg (range, 0.33 to 12×106/kg). Nineteen patients were evaluated for efficacy, among which 17 patients (89.5%) achieved MRD negative. The CR rates in the HLA-matched transplantation group and haploidentical transplantation group were 100% (7/7) and 83.3% (10/12), respectively. The median follow-up time was 9.80 months (range, 2.40 to 64.97). Ten patients (50%) died of relapse, 3 patients (15%) died of infection, and 1 patient (5%) died of aGVHD. Fifteen patients (75%) developed CRS, including 3 (20%) grade 1 CRS, 6 (40%) grade 2 CRS, and 6 (40%) grade 3 CRS. Ten patients (50%) developed aGVHD, including 1 (10%) grade I aGVHD, 6 (60%) grade II aGVHD, and 3 (30%) grade III aGVHD. The log rank test showed that CAR T cell origin was correlated with aGVHD occurrence in the haploidentical transplantation group (P = 0.005). The authors’ study indicated that the initial efficacy and safety of CAR T cell therapy for patients with post-transplant relapse were satisfactory. However, aGVHD was a concern in patients with a history of haploidentical transplantation occupied with allogeneic CAR T cells, which warrants clinical attention. Frontiers Media S.A. 2021-11-01 /pmc/articles/PMC8591161/ /pubmed/34790576 http://dx.doi.org/10.3389/fonc.2021.750218 Text en Copyright © 2021 Ding, Wang, Hong, Zhao, Zhou, Wei, Wu, Xu, Zhang, Luo, Shi, Chang, Hu and Huang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Ding, Lijuan
Wang, Yiyun
Hong, Ruimin
Zhao, Houli
Zhou, Linghui
Wei, Guoqing
Wu, Wenjun
Xu, Huijun
Zhang, Yanlei
Luo, Yi
Shi, Jimin
Chang, Alex H.
Hu, Yongxian
Huang, He
Efficacy and Safety of Chimeric Antigen Receptor T Cells in Acute Lymphoblastic Leukemia With Post-Transplant Relapse
title Efficacy and Safety of Chimeric Antigen Receptor T Cells in Acute Lymphoblastic Leukemia With Post-Transplant Relapse
title_full Efficacy and Safety of Chimeric Antigen Receptor T Cells in Acute Lymphoblastic Leukemia With Post-Transplant Relapse
title_fullStr Efficacy and Safety of Chimeric Antigen Receptor T Cells in Acute Lymphoblastic Leukemia With Post-Transplant Relapse
title_full_unstemmed Efficacy and Safety of Chimeric Antigen Receptor T Cells in Acute Lymphoblastic Leukemia With Post-Transplant Relapse
title_short Efficacy and Safety of Chimeric Antigen Receptor T Cells in Acute Lymphoblastic Leukemia With Post-Transplant Relapse
title_sort efficacy and safety of chimeric antigen receptor t cells in acute lymphoblastic leukemia with post-transplant relapse
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591161/
https://www.ncbi.nlm.nih.gov/pubmed/34790576
http://dx.doi.org/10.3389/fonc.2021.750218
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