Donor-derived CD19 CAR-T Cells versus Chemotherapy Plus Donor Lymphocyte Infusion for Treatment of Recurrent CD19-positive B-ALL After Allogeneic Hematopoietic Stem Cell Transplantation

作者全名："Tan, Xu; Wang, Xiao-qi; Zhang, Cheng; Zhao, Xian-lan; Yao, Han; Chen, Guo; Ma, Ying-ying; Wen, Qin; Gao, Lei; Gao, Li; Kong, Pei-yan; Shen, Yan; Zhang, Xi; Lou, Shi-feng"

作者地址："[Tan, Xu; Shen, Yan; Lou, Shi-feng] Chongqing Med Univ, Affiliated Hosp 2, Dept Hematol, Chongqing 400016, Peoples R China; [Tan, Xu; Wang, Xiao-qi; Zhang, Cheng; Zhao, Xian-lan; Yao, Han; Chen, Guo; Ma, Ying-ying; Wen, Qin; Gao, Lei; Gao, Li; Kong, Pei-yan; Zhang, Xi] Army Med Univ, Xinqiao Hosp, Med Ctr Hematol, State Key Lab Trauma Burns & Cobmined Injury, Chongqing 400037, Peoples R China; [Zhang, Xi] Jinfeng Lab, Chongqing 401329, Peoples R China"

通信作者："Lou, SF (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Hematol, Chongqing 400016, Peoples R China.; Zhang, X (通讯作者)，Army Med Univ, Xinqiao Hosp, Med Ctr Hematol, State Key Lab Trauma Burns & Cobmined Injury, Chongqing 400037, Peoples R China.; Zhang, X (通讯作者)，Jinfeng Lab, Chongqing 401329, Peoples R China."

来源：CURRENT MEDICAL SCIENCE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001009379600001

JCR分区：Q3

影响因子：2

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

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

摘要："ObjectiveThis 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 CD19-positive B-cell acute lymphoblastic leukemia (B-ALL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).MethodsClinical data of 43 patients with B-ALL who relapsed after allo-HSCT were retrospectively analyzed. Twenty-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 groups.ResultsThe 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 group. Two patients (9.1%) in the CAR-T group developed grade 1-2 aGVHD. Nineteen 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 ICANS.ConclusionDonor-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."

基金机构：National Natural Science Foundation of China [82020108004]; Hospital-level Clinical Innovation Military-Civilian Special Project of Army Medical University [2018JSLC0020]; Chongqing Science and Technology Innovation Leading Talent [CSTCCXLJRC201718]; Natural Science Foundation of Chongqing Innovation Group Science Program [cstc2021jcyj-cxttX0001]

基金资助正文："This work was 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), and Natural Science Foundation of Chongqing Innovation Group Science Program (No. cstc2021jcyj-cxttX0001)."