Efficacy and risk of donor-derived CAR-T treatment of relapsed B-cell acute lymphoblastic leukemia after hematopoietic stem cell transplantation.

IF 3.7 3区医学 Q2 BIOTECHNOLOGY & APPLIED MICROBIOLOGY

Cytotherapy Pub Date : 2024-05-26 DOI:10.1016/j.jcyt.2024.05.021

Lei Deng, Xiaolin Yu, Xiaocheng Song, Rui Guan, Wenjun Li, Yixi Hou, Yan Shao, Yuerong Zhao, Jing Wang, Yue Liu, Qianqian Xiao, Bo Xin, Fang Zhou

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引用次数: 0

Abstract

The one-year survival rate for patients experiencing a relapse of B-cell acute lymphocytic leukemia (B-ALL) following hematopoietic stem cell transplantation (HSCT) is approximately 30%. Patients experiencing a relapse after allogeneic HSCT frequently encounter difficulties in obtaining autologous CAR-T products. We conducted a study involving 14 patients who received donor-derived CAR-T therapy for relapsed B-ALL following HSCT between August 2019 and May 2023 in our center. The results revealed a CR/CRi rate of 78.6% (11/14), a GVHD rate of 21.4% (3/14), and a 1-year overall survival (OS) rate of 56%. Decreased bone marrow donor cell chimerism in 9 patients recovered after CAR-T therapy. The main causes of death were disease progression and infection. Further analysis showed that GVHD (HR 7.224, 95% CI 1.42-36.82, P = 0.017) and platelet recovery at 30 days (HR 6.807, 95% CI 1.61-28.83, P = 0.009) are significantly associated with OS after CAR-T therapy. Based on the findings, we conclude that donor-derived CAR-T cells are effective in treating relapsed B-ALL patients following HSCT. Additionally, GVHD and poor platelet recovery impact OS, but further verification with a larger sample size is needed.

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供体源性 CAR-T 治疗造血干细胞移植后复发 B 细胞急性淋巴细胞白血病的疗效与风险。

造血干细胞移植（HSCT）后复发的B细胞急性淋巴细胞白血病（B-ALL）患者的一年生存率约为30%。异基因造血干细胞移植后复发的患者常常难以获得自体CAR-T产品。我们开展了一项研究，在2019年8月至2023年5月期间，本中心有14名造血干细胞移植后复发的B-ALL患者接受了供体来源的CAR-T疗法。结果显示，CR/CRi率为78.6%（11/14），GVHD率为21.4%（3/14），1年总生存率（OS）为56%。9名患者的骨髓供体细胞嵌合率下降，在接受CAR-T疗法后得到恢复。死亡的主要原因是疾病进展和感染。进一步分析表明，GVHD（HR 7.224，95% CI 1.42-36.82，P = 0.017）和30天血小板恢复（HR 6.807，95% CI 1.61-28.83，P = 0.009）与CAR-T疗法后的OS显著相关。根据这些研究结果，我们得出结论：供体来源的 CAR-T 细胞能有效治疗造血干细胞移植后复发的 B-ALL 患者。此外，GVHD和血小板恢复不良也会影响OS，但还需要更大样本量的进一步验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cytotherapy 医学-生物工程与应用微生物

CiteScore

6.30

自引率

4.40%

发文量

683

审稿时长

49 days

期刊介绍： The journal brings readers the latest developments in the fast moving field of cellular therapy in man. This includes cell therapy for cancer, immune disorders, inherited diseases, tissue repair and regenerative medicine. The journal covers the science, translational development and treatment with variety of cell types including hematopoietic stem cells, immune cells (dendritic cells, NK, cells, T cells, antigen presenting cells) mesenchymal stromal cells, adipose cells, nerve, muscle, vascular and endothelial cells, and induced pluripotential stem cells. We also welcome manuscripts on subcellular derivatives such as exosomes. A specific focus is on translational research that brings cell therapy to the clinic. Cytotherapy publishes original papers, reviews, position papers editorials, commentaries and letters to the editor. We welcome "Protocols in Cytotherapy" bringing standard operating procedure for production specific cell types for clinical use within the reach of the readership.