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Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment
Measurable residual disease (MRD) positivity before haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is an independent prognostic factor in determining outcomes in patients with B-cell acute lymphoblastic leukemia (ALL). In this study, we conducted a parallel comparison of the eff...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207442/ https://www.ncbi.nlm.nih.gov/pubmed/35734165 http://dx.doi.org/10.3389/fimmu.2022.915590 |
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author | Hu, Guanhua Cheng, Yifei Zuo, Yingxi Chang, Yingjun Suo, Pan Jia, Yueping Lu, Aidong Wang, Yu Jiao, Shunchang Zhang, Longji Sun, Yuqian Yan, Chenhua Xu, Lanping Zhang, Xiaohui Liu, Kaiyan Wang, Yu Zhang, Leping Huang, Xiaojun |
author_facet | Hu, Guanhua Cheng, Yifei Zuo, Yingxi Chang, Yingjun Suo, Pan Jia, Yueping Lu, Aidong Wang, Yu Jiao, Shunchang Zhang, Longji Sun, Yuqian Yan, Chenhua Xu, Lanping Zhang, Xiaohui Liu, Kaiyan Wang, Yu Zhang, Leping Huang, Xiaojun |
author_sort | Hu, Guanhua |
collection | PubMed |
description | Measurable residual disease (MRD) positivity before haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is an independent prognostic factor in determining outcomes in patients with B-cell acute lymphoblastic leukemia (ALL). In this study, we conducted a parallel comparison of the efficacy and safety in patients with suboptimal MRD response after reinduction who underwent haplo-HSCT after chimeric antigen receptor T-cell (CAR-T) therapy or chemotherapy. Forty B-cell ALL patients who relapsed after first-line chemotherapy and with an MRD ≥0.1% after reinduction were analyzed. The median pre-HSCT MRD in the CAR-T group (n = 26) was significantly lower than that in the chemotherapy group (n = 14) (0.009% vs. 0.3%, p = 0.006). The CAR-T group exhibited a trend toward improved 3-year leukemia-free survival and a significantly improved 3-year overall survival compared to the chemotherapy group [71.8% (95% confidence interval (CI): 53.9–89.6) vs. 44.4% (95% CI: 15.4–73.4), p = 0.19 and 84.6% (95% CI: 70.6–98.5) vs. 40.0% (95% CI: 12.7–67.2), p = 0.008; respectively]. Furthermore, no increased risk of graft-versus-host disease, treatment-related mortality, or infection was observed in the CAR-T group. Our study suggests that CAR-T therapy effectively eliminates pre-HSCT MRD, resulting in better survival in the context of haplo-HSCT. |
format | Online Article Text |
id | pubmed-9207442 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92074422022-06-21 Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment Hu, Guanhua Cheng, Yifei Zuo, Yingxi Chang, Yingjun Suo, Pan Jia, Yueping Lu, Aidong Wang, Yu Jiao, Shunchang Zhang, Longji Sun, Yuqian Yan, Chenhua Xu, Lanping Zhang, Xiaohui Liu, Kaiyan Wang, Yu Zhang, Leping Huang, Xiaojun Front Immunol Immunology Measurable residual disease (MRD) positivity before haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is an independent prognostic factor in determining outcomes in patients with B-cell acute lymphoblastic leukemia (ALL). In this study, we conducted a parallel comparison of the efficacy and safety in patients with suboptimal MRD response after reinduction who underwent haplo-HSCT after chimeric antigen receptor T-cell (CAR-T) therapy or chemotherapy. Forty B-cell ALL patients who relapsed after first-line chemotherapy and with an MRD ≥0.1% after reinduction were analyzed. The median pre-HSCT MRD in the CAR-T group (n = 26) was significantly lower than that in the chemotherapy group (n = 14) (0.009% vs. 0.3%, p = 0.006). The CAR-T group exhibited a trend toward improved 3-year leukemia-free survival and a significantly improved 3-year overall survival compared to the chemotherapy group [71.8% (95% confidence interval (CI): 53.9–89.6) vs. 44.4% (95% CI: 15.4–73.4), p = 0.19 and 84.6% (95% CI: 70.6–98.5) vs. 40.0% (95% CI: 12.7–67.2), p = 0.008; respectively]. Furthermore, no increased risk of graft-versus-host disease, treatment-related mortality, or infection was observed in the CAR-T group. Our study suggests that CAR-T therapy effectively eliminates pre-HSCT MRD, resulting in better survival in the context of haplo-HSCT. Frontiers Media S.A. 2022-06-06 /pmc/articles/PMC9207442/ /pubmed/35734165 http://dx.doi.org/10.3389/fimmu.2022.915590 Text en Copyright © 2022 Hu, Cheng, Zuo, Chang, Suo, Jia, Lu, Wang, Jiao, Zhang, Sun, Yan, Xu, Zhang, Liu, Wang, Zhang 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 | Immunology Hu, Guanhua Cheng, Yifei Zuo, Yingxi Chang, Yingjun Suo, Pan Jia, Yueping Lu, Aidong Wang, Yu Jiao, Shunchang Zhang, Longji Sun, Yuqian Yan, Chenhua Xu, Lanping Zhang, Xiaohui Liu, Kaiyan Wang, Yu Zhang, Leping Huang, Xiaojun Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment |
title | Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment |
title_full | Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment |
title_fullStr | Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment |
title_full_unstemmed | Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment |
title_short | Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment |
title_sort | comparisons of long-term survival and safety of haploidentical hematopoietic stem cell transplantation after car-t cell therapy or chemotherapy in pediatric patients with first relapse of b-cell acute lymphoblastic leukemia based on mrd-guided treatment |
topic | Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207442/ https://www.ncbi.nlm.nih.gov/pubmed/35734165 http://dx.doi.org/10.3389/fimmu.2022.915590 |
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