Multiple CAR-T cell therapy for acute B-cell lymphoblastic leukemia after hematopoietic stem cell transplantation: A case report
B-cell acute lymphoblastic leukemia (B-ALL) is the most common childhood malignancy. The cure rate has reached 90% after conventional chemotherapy and hematopoietic stem cell transplantation (HSCT), but the prognosis of patients with relapsed and refractory (R/R) leukemia is still poor after convent...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1039929/full |
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| author | Lei Deng Yu Xiaolin Qian Wu Xiaochen Song Wenjun Li Yixi Hou Yue Liu Jing Wang Jun Tian Xiaona Zuo Fang Zhou |
| author_facet | Lei Deng Yu Xiaolin Qian Wu Xiaochen Song Wenjun Li Yixi Hou Yue Liu Jing Wang Jun Tian Xiaona Zuo Fang Zhou |
| author_sort | Lei Deng |
| collection | DOAJ |
| description | B-cell acute lymphoblastic leukemia (B-ALL) is the most common childhood malignancy. The cure rate has reached 90% after conventional chemotherapy and hematopoietic stem cell transplantation (HSCT), but the prognosis of patients with relapsed and refractory (R/R) leukemia is still poor after conventional treatment. Since FDA approved CD19 CAR-T cell (Kymriah) for the treatment of R/R B-ALL, increasing studies have been conducted on CAR-T cells for R/R ALL. Herein, we report the treatment of a patient with ALL who relapsed after allogeneic HSCT, had a complete remission (CR) to murine scFv CD19 CAR-T but relapsed 15 months later. Partial response was achieved after humanized CD19 CAR-T treatment, and the patient finally achieved disease-free survival after sequential CD22 CAR-T treatment. By comparing the treatment results of different CAR-T cells in the same patient, this case suggests that multiple CAR-T therapies are effective and safe in intramedullary and extramedullary recurrence in the same patient, and the expansion of CAR-T cells and the release of inflammatory cytokines are positively correlated with their efficacy. However, further clinical studies with large sample sizes are still needed for further clarification. |
| first_indexed | 2024-04-13T09:09:13Z |
| format | Article |
| id | doaj.art-89738469691c4de4afa359dc7d4e4f00 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-13T09:09:13Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-89738469691c4de4afa359dc7d4e4f002022-12-22T02:52:56ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-11-011310.3389/fimmu.2022.10399291039929Multiple CAR-T cell therapy for acute B-cell lymphoblastic leukemia after hematopoietic stem cell transplantation: A case reportLei Deng0Yu Xiaolin1Qian Wu2Xiaochen Song3Wenjun Li4Yixi Hou5Yue Liu6Jing Wang7Jun Tian8Xiaona Zuo9Fang Zhou10Hematology Department, The 960th Hospital of The People's Liberation Army (PLA) Joint Logistics Support Force, Jinan, ChinaHematology Department, The 960th Hospital of The People's Liberation Army (PLA) Joint Logistics Support Force, Jinan, ChinaHematology Department, The 960th Hospital of The People's Liberation Army (PLA) Joint Logistics Support Force, Jinan, ChinaHematology Department, The 960th Hospital of The People's Liberation Army (PLA) Joint Logistics Support Force, Jinan, ChinaHematology Department, The 960th Hospital of The People's Liberation Army (PLA) Joint Logistics Support Force, Jinan, ChinaHematology Department, The 960th Hospital of The People's Liberation Army (PLA) Joint Logistics Support Force, Jinan, ChinaHematology Department, The 960th Hospital of The People's Liberation Army (PLA) Joint Logistics Support Force, Jinan, ChinaHematology Department, The 960th Hospital of The People's Liberation Army (PLA) Joint Logistics Support Force, Jinan, ChinaNuclear Medicine Department, The 960th Hospital of the People’s Liberation Army (PLA) Joint Logistics Support Force, Jinan, ChinaDepartment of Pathology, Beijing Boren Hospital, Beijing, ChinaHematology Department, The 960th Hospital of The People's Liberation Army (PLA) Joint Logistics Support Force, Jinan, ChinaB-cell acute lymphoblastic leukemia (B-ALL) is the most common childhood malignancy. The cure rate has reached 90% after conventional chemotherapy and hematopoietic stem cell transplantation (HSCT), but the prognosis of patients with relapsed and refractory (R/R) leukemia is still poor after conventional treatment. Since FDA approved CD19 CAR-T cell (Kymriah) for the treatment of R/R B-ALL, increasing studies have been conducted on CAR-T cells for R/R ALL. Herein, we report the treatment of a patient with ALL who relapsed after allogeneic HSCT, had a complete remission (CR) to murine scFv CD19 CAR-T but relapsed 15 months later. Partial response was achieved after humanized CD19 CAR-T treatment, and the patient finally achieved disease-free survival after sequential CD22 CAR-T treatment. By comparing the treatment results of different CAR-T cells in the same patient, this case suggests that multiple CAR-T therapies are effective and safe in intramedullary and extramedullary recurrence in the same patient, and the expansion of CAR-T cells and the release of inflammatory cytokines are positively correlated with their efficacy. However, further clinical studies with large sample sizes are still needed for further clarification.https://www.frontiersin.org/articles/10.3389/fimmu.2022.1039929/fullB-ALLextramedullary recurrencehematopoietic (stem) cell transplantation (HCST)cytosineCAR (chimeric antigen receptor) T cells |
| spellingShingle | Lei Deng Yu Xiaolin Qian Wu Xiaochen Song Wenjun Li Yixi Hou Yue Liu Jing Wang Jun Tian Xiaona Zuo Fang Zhou Multiple CAR-T cell therapy for acute B-cell lymphoblastic leukemia after hematopoietic stem cell transplantation: A case report Frontiers in Immunology B-ALL extramedullary recurrence hematopoietic (stem) cell transplantation (HCST) cytosine CAR (chimeric antigen receptor) T cells |
| title | Multiple CAR-T cell therapy for acute B-cell lymphoblastic leukemia after hematopoietic stem cell transplantation: A case report |
| title_full | Multiple CAR-T cell therapy for acute B-cell lymphoblastic leukemia after hematopoietic stem cell transplantation: A case report |
| title_fullStr | Multiple CAR-T cell therapy for acute B-cell lymphoblastic leukemia after hematopoietic stem cell transplantation: A case report |
| title_full_unstemmed | Multiple CAR-T cell therapy for acute B-cell lymphoblastic leukemia after hematopoietic stem cell transplantation: A case report |
| title_short | Multiple CAR-T cell therapy for acute B-cell lymphoblastic leukemia after hematopoietic stem cell transplantation: A case report |
| title_sort | multiple car t cell therapy for acute b cell lymphoblastic leukemia after hematopoietic stem cell transplantation a case report |
| topic | B-ALL extramedullary recurrence hematopoietic (stem) cell transplantation (HCST) cytosine CAR (chimeric antigen receptor) T cells |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1039929/full |
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