概要
目的
尽管嵌合抗原受T(CAR-T)细胞桥接异基因造血干细胞移植(allo-HSCT)对于难治/复发B细胞恶性肿瘤已经显示出了显著的治疗效果,但仍有一小部分患者会出现疾病复发。
创新点
供体来源的CAR-T细胞可通过移植物的抗白血病作用发挥抗肿瘤作用,且安全性较好,因此可作为移植后复发B系急性淋巴细胞白血病(B-ALL)治疗的选择之一。
方法
本研究报告了一位62岁的女性患者,她被诊断为CD19阳性B-ALL。在首次自体CAR-T桥接异基因造血干细胞治疗后,患者很快出现髓外复发。随后患者接受了供体来源的CD19 CAR-T治疗。在回输一个月后,患者骨髓常规检查结果表明髓内无白血病细胞,并且MRD阴性。此外,正电子发射计算机断层扫描系统(PET/CT)提示髓外病灶完全消失。
结论
二次异体CAR-T治疗可以快速有效地治疗髓外白血病,且移植物抗宿主病(GVHD)发生风险低,因此可作为移植后疾病复发的治疗选择之一。
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Acknowledgments
This work was supported by the National Natural Science Foundation of China (Nos. 81730008, 82130003, and 81870153).
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Delin KONG contributed to reviewing the patient and writing the manuscript. Tingting YANG wrote part of the manuscript and reviewed the literature. Jia GENG supported the imaging materials of the patient and provided her comments on this manuscript. Ruirui JING, Qiqi ZHANG, and Guoqing WEI revised, edited, and checked the final version. He HUANG and Yongxian HU were mainly in charge of the patient, and critically reviewed the patient and the manuscript. All authors have read and approved the final manuscript, and therefore, have full access to all the data in the study and take responsibility for the integrity and security of the data.
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Delin KONG, Tingting YANG, Jia GENG, Ruirui JING, Qiqi ZHANG, Guoqing Wei, He HUANG, and Yongxian HU declare that they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (the Ethics Review Committee of the First Affiliated Hospital of Zhejiang University (No. NCT04532268)) and with the Helsinki Declaration of 1975, as revised in 2008(5). Informed consent was obtained from the patient for being included in the report.
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Kong, D., Yang, T., Geng, J. et al. Secondary donor-derived CD19 CAR-T therapy is safe and efficacious in acute lymphoblastic leukemia with extramedullary relapse after first autologous CAR-T therapy. J. Zhejiang Univ. Sci. B 23, 876–880 (2022). https://doi.org/10.1631/jzus.B2200128
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DOI: https://doi.org/10.1631/jzus.B2200128