Donor-derived CD 19 CAR-T Cells versus Chemotherapy Plus Donor Lymphocyte Infusion for Treatment of Recurrent CD 19-positive B-ALL after Allogeneic Hematopoietic Stem Cell Transplantation

作     者：Xu TAN Xiao-qi WANG Cheng ZHANG Xian-lan ZHAO Han YAO Guo CHEN Ying-ying MA Qin WEN Lei GAO Li GAO Pei-yan KONG Yan SHEN Xi ZHANG Shi-feng LOU Xu TAN;Xiao-qi WANG;Cheng ZHANG;Xian-lan ZHAO;Han YAO;Guo CHEN;Ying-ying MA;Qin WEN;Lei GAO;Li GAO;Pei-yan KONG;Yan SHEN;Xi ZHANG;Shi-feng LOU

作者机构：Department of Hematologythe Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Medical Center of HematologyXinqiao HospitalState Key Laboratory of TraumaBurns and Cobmined InjuryArmy Medical UniversityChongqing 400037China Jinfeng LaboratoryChongqing 401329China 

出 版 物：《当代医学科学(英文)》 (Current Medical Science)

年 卷 期：2023年第43卷第4期

页      面：733-740页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：supported by grants from the National Natural Science Foundation of China(No.82020108004) the Hospital-level Clinical Innovation Military-Civilian Special Project of Army Medical University(No.2018JSLC0020) Chongqing Science and Technology Innovation Leading Talent(No.CSTCCXLJRC201718) Natural Science Foundation of Chongqing Innovation Group Science Program(No.cstc2021jcyj-cxttX0001) 

主　　题：CD19-positive B-cell acute lymphoblastic leukemia relapse donor-derived CD19 chimeric antigen receptor T cells chemo-donor lymphocyte infusion 

摘      要：Objective:This study aimed to compare the efficacy of anti-CD19 chimeric antigen receptor T cells(CAR-T cells)versus chemotherapy plus donor lymphocyte infusion(chemo-DLI)for treating relapsed CD 19-positive B-cell acute lymphoblastic leukemia(B-ALL)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods:Clinical data of 43 patients with B-ALL who relapsed after allo-HSCT were retrospectively ***-two patients were treated with CAR-T cells(CAR-T group),and 21 with chemotherapy plus DLI(chemo-DLI group).The complete remission(CR)and minimal residual disease(MRD)-negative CR rates,leukemia-free survival(LFS)rate,overall survival(OS)rate,and incidence of acute graft-versus-host disease(aGVHD),cytokine release syndrome(CRS)and immune effector cell-associated neurotoxicity syndrome(ICANS)were compared between the two ***:The CR and MRD-negative CR rates in the CAR-T group(77.3%and 61.5%)were significantly higher than those in the chemo-DLI group(38.1%and 23.8%)(P=0.008 and P=0.003).The 1-and 2-year LFS rates in the CAR-T group were superior to those in the chemo-DLI group:54.5%and 50.0%vs.9.5%and 4.8%(P=0.0001 and P=0.00004).The 1-and 2-year OS rates in the CAR-T versus chemo-DLI group were 59.1%and 54.5%vs.19%and 9.5%(P=0.011 and P=0.003).Six patients(28.6%)with grade 2-4 aGVHD were identified in the chemo-DLI *** patients(9.1%)in the CAR-T group developed grade 1-2 *** patients(86.4%)developed CRS in the CAR-T group,comprising grade 1-2 CRS in 13 patients(59.1%)and grade 3 CRS in 6 patients(27.3%).Two patients(9.1%)developed grade 1-2 ***:Donor-derived anti-CD19 CAR-T-cell therapy may be better,safer,and more effective than chemo-DLI for B-ALL patients who relapse after allo-HSCT.