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On-line Access: 2022-10-12

Received: 2022-03-14

Revision Accepted: 2022-05-17

Crosschecked: 2022-10-13

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 ORCID:

Yongxian HU

https://orcid.org/0000-0001-9564-1852

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Journal of Zhejiang University SCIENCE B 2022 Vol.23 No.10 P.876-880

http://doi.org/10.1631/jzus.B2200128


Secondary donor-derived CD19 CAR-T therapy is safe and efficacious in acute lymphoblastic leukemia with extramedullary relapse after first autologous CAR-T therapy


Author(s):  Delin KONG, Tingting YANG, Jia GENG, Ruirui JING, Qiqi ZHANG, Guoqing WEI, He HUANG, Yongxian HU

Affiliation(s):  Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; more

Corresponding email(s):   1313016@zju.edu.cn

Key Words:  Extramedullary relapse, Allogeneic anti-CD19 chimeric antigen receptor T cells, Haploidentical hematopoietic stem cell transplantation, Acute lymphoblastic leukemia


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Delin KONG, Tingting YANG, Jia GENG, Ruirui JING, Qiqi ZHANG, Guoqing WEI, He HUANG, Yongxian HU. Secondary donor-derived CD19 CAR-T therapy is safe and efficacious in acute lymphoblastic leukemia with extramedullary relapse after first autologous CAR-T therapy[J]. Journal of Zhejiang University Science B, 2022, 23(10): 876-880.

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author="Delin KONG, Tingting YANG, Jia GENG, Ruirui JING, Qiqi ZHANG, Guoqing WEI, He HUANG, Yongxian HU",
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volume="23",
number="10",
pages="876-880",
year="2022",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B2200128"
}

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A1 - He HUANG
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Abstract: 
Despite the advancement of treatments, adults with relapsed/refractory (R/R) B-lineage acute lymphoblastic leukemia (B-ALL) have poor prognosis, with an expected five-year overall survival (OS) rate of 10%‒20% (Nguyen et al., 2008; Oriol et al., 2010). extramedullary relapse of B-ALL is regarded as a high-risk factor generally associated with poor survival, occurring in about 15% to 20% of all relapsed patients (Ding et al., 2017; Sun et al., 2018). The central nervous system (CNS) and the testes are the most common sites of extramedullary relapse of B-ALL. In addition, extramedullary leukemia can appear in the skin, eyes, breasts, bones, muscles, and abdominal organs. The prognosis of relapsed extramedullary B-ALL after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is extremely poor (Spyridonidis et al., 2012; Dahlberg et al., 2019). Conventional chemotherapy or radiation is often ineffective in such patients. At present, there are no optimal treatment strategies for treating extramedullary leukemia after allo-HSCT.

自体CAR-T治疗后髓外复发的性淋巴细胞白血病患者再次应用供体来源的CD19 CAR-T治疗是安全有效的

孔德麟1,2,3,4,杨婷婷1,2,3,4,耿佳5,荆瑞瑞1,2,3,4,张棋琦1,2,3,4,魏国庆1,2,3,4,黄河1,2,3,4,胡永仙1,2,3,4
1浙江大学医学院附属第一医院骨髓移植中心,中国杭州市,310003
2浙江大学医学中心良渚实验室,中国杭州市,311121
3浙江大学血液学研究所,中国杭州市,310058
4干细胞与细胞免疫治疗浙江省工程研究中心,中国杭州市,310058
5浙江大学医学院附属第一医院放射科,中国杭州市,310003
目的:尽管嵌合抗原受T(CAR-T)细胞桥接异基因造血干细胞移植(allo-HSCT)对于难治/复发B细胞恶性肿瘤已经显示出了显著的治疗效果,但仍有一小部分患者会出现疾病复发。
创新点:供体来源的CAR-T细胞可通过移植物的抗白血病作用发挥抗肿瘤作用,且安全性较好,因此可作为移植后复发B系急性淋巴细胞白血病(B-ALL)治疗的选择之一。
方法:本研究报告了一位62岁的女性患者,她被诊断为CD19阳性B-ALL。在首次自体CAR-T桥接异基因造血干细胞治疗后,患者很快出现髓外复发。随后患者接受了供体来源的CD19 CAR-T治疗。在回输一个月后,患者骨髓常规检查结果表明髓内无白血病细胞,并且MRD阴性。此外,正电子发射计算机断层扫描系统(PET/CT)提示髓外病灶完全消失。
结论:二次异体CAR-T治疗可以快速有效地治疗髓外白血病,且移植物抗宿主病(GVHD)发生风险低,因此可作为移植后疾病复发的治疗选择之一。

关键词:嵌合抗原受T细胞(CAR-T);髓外复发;异基因造血干细胞移植

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

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