CD19-Specific CAR-T Cell Treatment of 115 Children and Young Adults with Acute B Lymphoblastic Leukemia: Long-term Follow-up

被引:1
作者
Wang, Yu [1 ]
Xue, Yu-juan [1 ]
Zuo, Ying-xi [1 ]
Jia, Yue-ping [1 ]
Lu, Ai-dong [1 ]
Zeng, Hui-min [1 ]
Zhang, Le-ping [1 ]
机构
[1] Peking Univ, Peking Univ Peoples Hosp, 11 Xizhimen South St, Beijing 100044, Peoples R China
来源
CANCER RESEARCH AND TREATMENT | 2024年 / 56卷 / 03期
基金
中国国家自然科学基金;
关键词
CD19 CAR-T therapy; R/R B-ALL; MRD re-emergence; Prognosis; THERAPY;
D O I
10.4143/crt.2023.1205
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose Chemotherapy has been the primary treatment for patients with B-cell acute lymphoblastic leukemia (B-ALL). However, there are still patients who are not sensitive to chemotherapy, including those with refractory/relapse (R/R) disease and those experiencing minimal residual disease (MRD) re-emergence. Chimeric antigen receptor-T lymphocytes (CAR-T) therapy may provide a new treatment option for these patients. Materials and Methods Our institution conducted a single-arm prospective clinical trial (ChiCTR-OPN-17013507) using CAR-T-19 to treat R/R B-ALL and MRD re-emergent patients. One hundred and fifteen patients, aged 1-25 years (median age, 8 years), were enrolled, including 67 R/R and 48 MRD re-emergent CD19-positive B-ALL patients. Results All patients achieved morphologic complete remission (CR), and within 1 month after infusion, 111 out of 115 (96.5%) patients achieved MRD-negative CR. With a median follow-up time of 48.4 months, the estimated 4-year leukemia-free survival (LFS) rate and overall survival (OS) rate were 68.7%+/- 4.5% and 70.7%+/- 4.3%, respectively. There were no significant differences in longterm efficacy observed among patients with different disease statuses before infusion (4-year OS: MRD re-emergence vs. R/R B-ALL, 70.6%+/- 6.6% vs. 66.5%+/- 6.1%, p=0.755; 4-year LFS: MRD re-emergence vs. R/R B-ALL, 67.3%+/- 7.0% vs. 63.8%+/- 6.2%, p=0.704). R/R B-ALL patients bridging to transplantation after CAR-T treatment had a superior OS and LFS compared to those who did not. However, for MRD re-emergent patients, there was no significant difference in OS and LFS, regardless of whether they underwent hematopoietic stem cell transplantation or not. Conclusion CD19 CAR-T therapy effectively and safely cures both R/R B-ALL and MRD re-emergent patients.
引用
收藏
页码:945 / 955
页数:11
相关论文
共 21 条
[1]   Influence of patient characteristics on chimeric antigen receptor T cell therapy in B-cell acute lymphoblastic leukemia [J].
An, Furun ;
Wang, Huiping ;
Liu, Zhenyun ;
Wu, Fan ;
Zhang, Jiakui ;
Tao, Qianshan ;
Li, Yingwei ;
Shen, Yuanyuan ;
Ruan, Yanjie ;
Zhang, Qing ;
Pan, Ying ;
Zhu, Weiwei ;
Qin, Hui ;
Wang, Yansheng ;
Fu, Yongling ;
Feng, Zhenqing ;
Zhai, Zhimin .
NATURE COMMUNICATIONS, 2020, 11 (01)
[2]   Outcome of children with newly diagnosed acute lymphoblastic leukemia treated with CCLG-ALL 2008: The first nation-wide prospective multicenter study in China [J].
Cui, Lei ;
Li, Zhi-Gang ;
Chai, Yi-Huan ;
Yu, Jie ;
Gao, Ju ;
Zhu, Xiao-Fan ;
Jin, Run-Ming ;
Shi, Xiao-Dong ;
Zhang, Le-Ping ;
Gao, Yi-Jin ;
Zhang, Rui-Dong ;
Zheng, Hu-Yong ;
Hu, Shao-Yan ;
Cui, Ying-Hui ;
Zhu, Yi-Ping ;
Zou, Yao ;
Ng, Margaret H. L. ;
Xiao, Yan ;
Li, Jun-Hui ;
Zhang, Yong-Hong ;
He, Hai-Long ;
Xian, Ying ;
Wang, Tian-You ;
Li, Chi-Kong ;
Wu, Min-Yuan .
AMERICAN JOURNAL OF HEMATOLOGY, 2018, 93 (07) :913-920
[3]   Idelalisib sensitivity and mechanisms of disease progression in relapsed TCF3-PBX1 acute lymphoblastic leukemia [J].
Eldfors, S. ;
Kuusanmaki, H. ;
Kontro, M. ;
Majumder, M. M. ;
Parsons, A. ;
Edgren, H. ;
Pemovska, T. ;
Kallioniemi, O. ;
Wennerberg, K. ;
Gokbuget, N. ;
Burmeister, T. ;
Porkka, K. ;
Heckman, C. A. .
LEUKEMIA, 2017, 31 (01) :51-57
[4]   Factors associated with durable EFS in adult B-cell ALL patients achieving MRD-negative CR after CD19 CAR T-cell therapy [J].
Hay, Kevin A. ;
Gauthier, Jordan ;
Hirayama, Alexandre V. ;
Voutsinas, Jenna M. ;
Wu, Qian ;
Li, Daniel ;
Gooley, Ted A. ;
Cherian, Sindhu ;
Chen, Xueyan ;
Pender, Barbara S. ;
Hawkins, Reed M. ;
Vakil, Aesha ;
Steinmetz, Rachel N. ;
Schoch, Gary ;
Chapuis, Aude G. ;
Till, Brian G. ;
Kiem, Hans-Peter ;
Ramos, Jorge D. ;
Shadman, Mazyar ;
Cassaday, Ryan D. ;
Acharya, Utkarsh H. ;
Riddell, Stanley R. ;
Maloney, David G. ;
Turtle, Cameron J. .
BLOOD, 2019, 133 (15) :1652-1663
[5]   Chimeric Antigens Receptor T Cell Therapy Improve the Prognosis of Pediatric Acute Lymphoblastic Leukemia With Persistent/Recurrent Minimal Residual Disease in First Complete Remission [J].
Hu, Guan-hua ;
Cheng, Yi-fei ;
Zuo, Ying-xi ;
Chang, Ying-jun ;
Suo, Pan ;
Wu, Jun ;
Jia, Yue-ping ;
Lu, Ai-dong ;
Li, Ying-chun ;
Wang, Yu ;
Jiao, Shun-chang ;
Zhang, Long-ji ;
Zhao, Xiang-yu ;
Yan, Chen-hua ;
Xu, Lan-ping ;
Zhang, Xiao-hui ;
Liu, Kai-yan ;
Zhang, Le-ping ;
Huang, Xiao-jun .
FRONTIERS IN IMMUNOLOGY, 2022, 12
[6]   Unmanipulated haploidentical hematopoietic stem cell transplantation is an excellent option for children and young adult relapsed/refractory Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia after CAR-T-cell therapy [J].
Hu, Guan-Hua ;
Zhao, Xiang-Yu ;
Zuo, Ying-Xi ;
Chang, Ying-Jun ;
Suo, Pan ;
Wu, Jun ;
Jia, Yue-Ping ;
Lu, Ai-Dong ;
Li, Ying-Chun ;
Wang, Yu ;
Jiao, Shun-Chang ;
Zhang, Long-Ji ;
Kong, Jun ;
Yan, Chen-Hua ;
Xu, Lan-Ping ;
Zhang, Xiao-Hui ;
Liu, Kai-Yan ;
Cheng, Yi-Fei ;
Wang, Yu ;
Zhang, Le-Ping ;
Huang, Xiao-Jun .
LEUKEMIA, 2021, 35 (11) :3092-3100
[7]   Outcome of Reinduction Chemotherapy with a Modified Dose of Idarubicin for Children with Marrow-Relapsed Acute Lymphoblastic Leukemia: Results of the Childhood Acute Lymphoblastic Leukemia (CALL)-0603 Study [J].
Koh, Kyung-Nam ;
Im, Ho Joon ;
Kim, Hyery ;
Kang, Hyoung Jin ;
Park, Kyung Duk ;
Shin, Hee Young ;
Ahn, Hyo Seop ;
Lee, Ji Won ;
Yoo, Keon Hee ;
Sung, Ki Woong ;
Koo, Hong Hoe ;
Lim, Young Tak ;
Park, Jun Eun ;
Park, Byung-Kiu ;
Park, Hyeon Jin ;
Seo, Jong Jin .
JOURNAL OF KOREAN MEDICAL SCIENCE, 2017, 32 (04) :642-649
[8]   ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells [J].
Lee, Daniel W. ;
Santomasso, Bianca D. ;
Locke, Frederick L. ;
Ghobadi, Armin ;
Turtle, Cameron J. ;
Brudno, Jennifer N. ;
Maus, Marcela, V ;
Park, Jae H. ;
Mead, Elena ;
Pavletic, Steven ;
Go, William Y. ;
Eldjerou, Lamis ;
Gardner, Rebecca A. ;
Frey, Noelle ;
Curran, Kevin J. ;
Peggs, Karl ;
Pasquini, Marcelo ;
DiPersio, John F. ;
van den Brink, Marcel R. M. ;
Komanduri, Krishna, V ;
Grupp, Stephan A. ;
Neelapu, Sattva S. .
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2019, 25 (04) :625-638
[9]   Involvement of the central nervous system in acute lymphoblastic leukemia: opinions on molecular mechanisms and clinical implications based on recent data [J].
Lenk, Lennart ;
Alsadeq, Ameera ;
Schewe, Denis M. .
CANCER AND METASTASIS REVIEWS, 2020, 39 (01) :173-187
[10]   CAR-T therapy followed by allogeneic hematopoietic stem cell transplantation for refractory/relapsed acute B lymphocytic leukemia: Long-term follow-up results [J].
Li, Zhihui ;
Yang, Keyan ;
Song, Yanzhi ;
Zhao, Yongqiang ;
Wu, Fan ;
Wen, Xiaopei ;
Li, Jing ;
Wang, Xianxuan ;
Xu, Teng ;
Zheng, Xiaoyu ;
Zheng, Qinglong ;
Wu, Tong .
FRONTIERS IN ONCOLOGY, 2023, 12