Outcomes of Anti-CD19 CAR-T Treatment of Pediatric B-ALL with Bone Marrow and Extramedullary Relapse
| العنوان: | Outcomes of Anti-CD19 CAR-T Treatment of Pediatric B-ALL with Bone Marrow and Extramedullary Relapse |
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| المؤلفون: | Xiang Wang, Yani Ma, Yanjing Tang, Lixia Ding, Jingyan Tang, Yan Miao, Xinyu Wan, Long-Jun Gu, Xiaomin Yang, Tianyi Wang, Fan Yang, Chengjuan Luo, Jun Lu, Lili Song, Benshang Li, Jing Chen |
| المصدر: | Cancer Research and Treatment. 54:917-925 |
| بيانات النشر: | Korean Cancer Association, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Cancer Research, medicine.medical_specialty, medicine.medical_treatment, Antigens, CD19, Hematopoietic stem cell transplantation, Immunotherapy, Adoptive, Gastroenterology, CD19, Viral vector, Refractory, Bone Marrow, Recurrence, Internal medicine, medicine, Humans, Child, Receptors, Chimeric Antigen, biology, business.industry, Immunotherapy, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Chimeric antigen receptor, Clinical trial, medicine.anatomical_structure, Oncology, biology.protein, Bone marrow, business |
| الوصف: | Purpose Anti-CD19 chimeric antigen receptor T-cell immunotherapy (19CAR-T) has achieved impressive clinical results in adult and pediatric relapsed/refractory (r/r) B-lineage acute lymphoblastic leukemia (B-ALL). However, the application and effect of CAR-T therapy in B-ALL patients with extramedullary relapse are rarely issued even disqualified in some clinical trials. Here, we examined the efficacy of 19CAR-T in patients with both bone marrow and extramedullary involvement. Materials and methods CAR-T cells were generated by transfection of primary human T lymphocytes with a lentiviral vector expressing anti-CD19 single chain antibody fragments (scFvs) with the cytoplasmic domains of 4-1BB and CD3ζ, and used to infuse patients diagnosed as having r/r B-ALL with extramedullary origination. Clinical responses were evaluated by the use of bone marrow aspiration, imaging, and flow cytometry. Results Eight patients received 19CAR-T infusion and all attained complete remission (CR). Only one patient was bridged to hematopoietic stem cell transplantation (HSCT). Although three patients relapsed after infusion, they received 19/22CAR-T infusion sequentially and attained a second remission. To date, five patients are in continuous CR and all eight patients are still alive. The mean follow-up time was 21.9 months, while the 24-month estimated event-free survival is 51.4%. Conclusion Anti-CD19 CAR-T therapy can lead to clinical remission for extramedullary relapsed pediatric B-ALL patients. However, the problem of CD19+ relapses after CAR-T remained to be solved. For patients relapsing after CAR-T, a second CAR-T therapy creates another opportunity for remission for subsequent HSCT. |
| تدمد: | 2005-9256 1598-2998 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fb09059a9a8eb5aff093035b93ce662d https://doi.org/10.4143/crt.2021.399 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....fb09059a9a8eb5aff093035b93ce662d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20059256 15982998 |
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