Long-term follow-up of CD19 chimeric antigen receptor T-cell therapy for relapsed/refractory acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation

被引：37

作者：

Chen, Yu-Hong ^{[1
]}

Zhang, Xian ^{[2
]}

Cheng, Yi-Fei ^{[1
]}

Chen, Huan ^{[1
]}

Mo, Xiao-Dong ^{[1
]}

Yan, Chen-Hua ^{[1
]}

Chen, Yao ^{[1
]}

Han, Wei ^{[1
]}

Sun, Yu-Qian ^{[1
]}

Wang, Yu ^{[1
]}

Zhang, Xiao-Hui ^{[1
]}

Xu, Lan-Ping ^{[1
]}

Liu, Kai-Yan ^{[1
]}

Yang, Junfang ^{[2
]}

Zhang, Jianping ^{[2
]}

Zhang, Gai-Ling ^{[2
]}

Shi, Yanze ^{[2
]}

Su, Yun-Chao ^{[2
]}

Li, Wen-Qian ^{[2
]}

Xu, Li ^{[2
]}

Song, Dan ^{[2
]}

Zhang, Min ^{[2
]}

Lu, Peihua ^{[2
]}

Huang, Xiao-Jun ^{[1
]}

机构：

[1] Peking Univ, Beijing Key Lab Hematopoiet Stem Cell Transplanta, Natl Clin Res Ctr Hematol Dis, Peoples Hosp,Inst Hematol, 11 Xizhimen South St, Beijing 100044, Peoples R China

[2] Hebei Yanda Lu Daopei Hosp, Langfang, Peoples R China

来源：

CYTOTHERAPY | 2020年 / 22卷 / 12期

基金：

中国国家自然科学基金;

关键词：

acute lymphoblastic leukemia; allogeneic hematopoietic stem cell transplantation; CD19-targeted chimeric antigen receptor; T cells; ALL; HCT; CD19; CAR; VERSUS-HOST-DISEASE; DONOR; REMISSIONS; SAFETY;

D O I：

10.1016/j.jcyt.2020.08.002

中图分类号：

Q813 [细胞工程];

学科分类号：

摘要：

Background aims: The efficacy of CD19-targeted chimeric antigen receptor T (CAR T) cells for treatment of relapsed B-cell malignancies after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and the long-term outcomes of these patients remain inconclusive. Methods: The authors focused on the survival of 35 patients with B-cell acute lymphoblastic leukemia who relapsed after allo-HSCT and received CART cells. Results: Of the 34 eligible patients, 30 achieved minimal residual disease-negative complete remission (CR), with a total CR rate of 85.7% (79.8-91.6%). There were 14 patients who received various forms of additional therapy after achieving CR. After a median follow-up of 20.7 months, it was noted that 17 patients had relapsed at a median of 4.5 months (2-34 months). The cumulative recurrence rate (RR) at 18 months was 68.3% (57.6-79.0%). Additional treatment did not reduce the RR but seemed to delay the time to relapse (mean: 5.9 months vs 13.1 months; P = 0.046). Patients with a lower tumor burden (<10%) had a lower RR (25.0% vs 78.6% at 12 months; P = 0.006). The overall survival (OS) rate for the CR patients was 30.0% (20.3-29.7%) at 18 months, with a median OS of 12.7 months. Conclusions: The authors' study indicated that for patients who relapsed after HSCT, although a high CR rate was achieved after CART therapy, the long-term efficacy was unsatisfactory. It is necessary to optimize additional treatment, including a second HSCT, to further improve long-term efficacy after CART infusion. (C) 2020 International Society for Cell & Gene Therapy. Published by Elsevier Inc. All rights reserved.

引用

页码：755 / 761

页数：7

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