Allogeneic Donor-Derived Anti-CD19 CAR T Cell Is a Promising Therapy for Relapsed/Refractory B-ALL After Allogeneic Hematopoietic Stem-Cell Transplantation

Jingsheng Hua; Jian Zhang; Xiaoxia Wu; Lili Zhou; Xiebing Bao; Yue Han; Miao Miao; Caixia Li; Zhengzheng Fu; Depei Wu; Weiqing Qian; Huiying Qiu

doi:10.1016/j.clml.2020.04.007

Allogeneic Donor-Derived Anti-CD19 CAR T Cell Is a Promising Therapy for Relapsed/Refractory B-ALL After Allogeneic Hematopoietic Stem-Cell Transplantation

Clin Lymphoma Myeloma Leuk. 2020 Sep;20(9):610-616. doi: 10.1016/j.clml.2020.04.007. Epub 2020 Apr 18.

Authors

Jingsheng Hua¹, Jian Zhang², Xiaoxia Wu², Lili Zhou², Xiebing Bao², Yue Han², Miao Miao², Caixia Li², Zhengzheng Fu², Depei Wu³, Weiqing Qian⁴, Huiying Qiu⁵

Affiliations

¹ Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, PR China; Department of Hematology, Taizhou Municipal Hospital, Taizhou, Zhejiang, PR China.
² Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, PR China.
³ Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, PR China. Electronic address: drwudepei@163.com.
⁴ School of Clinical Medicine, Suzhou Vocational Health College, Suzhou, Jiangsu, PR China. Electronic address: qianweiqing196512@163.com.
⁵ Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, PR China. Electronic address: qiuhuiying8303@suda.edu.cn.

PMID: 32507386
DOI: 10.1016/j.clml.2020.04.007

Abstract

Introduction: Currently, effective and safe salvage therapies are limited among patients with relapsed acute lymphoblastic leukemia after allogeneic hematopoietic stem-cell transplantation (allo-HSCT). Anti-CD19 chimeric antigen receptor T (CAR T) cell is a promising treatment.

Patients and methods: We studied 11 patients with B-cell acute lymphoblastic leukemia that relapsed after allo-HSCT between September 2017 and October 2019. Patients were treated with a dose of single-infusion donor-derived anti-CD19 CAR T cells.

Results: Eight patients (72.7%) experienced morphologic remissions. Seven (63.6%) experienced minimal residual disease-negative remission. The ongoing complete remission (CR) duration of 2 patients reached 22 months. The median overall survival was 9 months (range, 2-22 months). Only one patient with grade 1 acute graft-versus-host disease was observed. Two patients (18.2%) developed grade 3/4 cytokine release syndrome.

Conclusion: This prospective study showed allogeneic donor-derived anti-CD19 CAR T-cell therapy is an effective and safe salvage regimen for patients with relapsed/refractory B-cell acute lymphoblastic leukemia after allo-HSCT. Further randomized and multicenter investigations are needed to evaluate their potential role in relapsed acute lymphoblastic leukemia therapies after allo-HSCT.

Keywords: Acute lymphoblastic leukemia; CD19; Chimeric antigen receptor; Donor-derived; Hematopoietic Stem Cell Transplantation; Relapse.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Child
Female
Hematopoietic Stem Cell Transplantation / methods*
Humans
Male
Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
Prospective Studies
Receptors, Chimeric Antigen / immunology*
T-Lymphocytes / immunology*
Transplantation Conditioning / methods*
Transplantation, Homologous / methods*
Young Adult

Substances

Receptors, Chimeric Antigen