首页|供者来源CAR-T细胞治疗异基因造血干细胞移植后复发急性B淋巴细胞白血病的疗效及安全性

供者来源CAR-T细胞治疗异基因造血干细胞移植后复发急性B淋巴细胞白血病的疗效及安全性

Safety and efficacy of donor-derived chimeric antigen receptor T-cell therapy in patients with relapsed B-cell acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation

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目的 探索供者来源靶向CD19或联合靶向CD22嵌合抗原受体T细胞(CAR-T细胞)治疗异基因造血干细胞移植后复发急性B淋巴细胞白血病(B-ALL)的有效性及安全性.方法 回顾性分析2015年9月至2022年12月在南方医科大学珠江医院及解放军联勤保障部队第九二○医院血液科22例接受供者来源CAR-T细胞治疗的异基因造血干细胞移植后复发的B-ALL患者的有效性和安全性.主要研究终点是总生存(OS),次要研究终点是无事件生存(EFS)、完全缓解(CR)率、3~4级不良事件.结果CAR-T细胞输注后,18例(81.82%)患者获得CR且微小残留病(MRD)均为阴性.中位随访 1037(95%CI546~1509)d,中位OS期为287(95%CI 132~441)d,中位EFS期为212(95%CI 120~303)d,6 个月 OS 率为 67.90%(95%CI 48.30%~84.50%),6 个月 EFS 率为 58.70%(95%CI 37.92%~79.48%),1 年 OS 率为 41.10%(95%CI 19.15%~63.05%),1 年 EFS 率为 34.30%(95%CI 13.92%~54.68%).3例(13.64%)患者发生≥3级细胞因子释放综合征(CRS),未发生免疫效应细胞相关神经毒性综合征(ICANS),2例患者发生急性移植物抗宿主病(aGVHD)(分别为Ⅱ度和Ⅳ度).结论 供者来源CAR-T细胞治疗异基因造血干细胞移植后复发B-ALL是一种安全有效的治疗策略.
Objective To investigated the safety and efficacy of donor-derived CD 19+or sequential CD 19+CD22+chimeric antigen receptor T-cell(CAR-T)therapy in patients with B-cell acute lymphoblastic leukemia(B-ALL)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods The data of 22 patients with B-ALL who relapsed after allo-HSCT and who underwent donor-derived CAR-T therapy at the Zhujiang Hospital of Southern Medical University and the 920th Hospital of Joint Logistics Support Force of the People's Liberation Army of China from September 2015 to December 2022 were retrospectively analyzed.The primary endpoint was overall survival(OS),and the secondary endpoints were event-free survival(EFS),complete remission(CR)rate,and Grade 3-4 adverse events.Results A total of 81.82%(n=18)of the 22 patients achieved minimal residual disease-negative CR after CAR-T infusion.The median follow-up time was 1037(95%CI 546-1509)days,and the median OS and EFS were 287(95%CI 132-441)days and 212(95%CI 120-303)days,respectively.The 6-month OS and EFS rates were 67.90%(95%CI 48.30%-84.50%)and 58.70%(95%CI 37.92%-79.48%),respectively,and the 1-year OS and EFS rates were 41.10%(95%CI 19.15%-63.05%)and 34.30%(95%CI 13.92%-54.68%),respectively.Grade 1-2 cytokine release syndrome occurred in 36.36%(n=8)of the patients,and grade 3-4 occurred in 13.64%of the patients(n=3).Grade 2 and 4 graft-versus-host disease occurred in two patients.Conclusion Donor-derived CAR-T therapy is safe and effective in patients with relapsed B-ALL after allo-HSCT.

Donor-derivedChimeric antigen receptorAllogeneic hematopoietic stem cell transplantationB-cell acute lymphoblastic leukemiaRelapsed

卓亚琪、涂三芳、周璇、杨继龙、周丽娟、黄睿、黄宇贤、李梅芳、金波、王博、黎诗琦、袁忠涛、张丽华、刘林、王三斌、李玉华

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南方医科大学珠江医院血液科,广州 510280

解放军联勤保障部队第九二○医院血液科,昆明 650118

供者来源 嵌合抗原受体 异基因造血干细胞移植 急性B淋巴细胞白血病 复发

国家自然科学基金国家自然科学基金国家自然科学基金重点项目云南省科技重大专项生物医药专项

8227023382200246U2001224202102AA100011

2024

中华血液学杂志
中华医学会

中华血液学杂志

CSTPCD北大核心
影响因子:1.17
ISSN:0253-2727
年,卷(期):2024.45(1)
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