Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment
Measurable residual disease (MRD) positivity before haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is an independent prognostic factor in determining outcomes in patients with B-cell acute lymphoblastic leukemia (ALL). In this study, we conducted a parallel comparison of the eff...
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-06-01
|
| Series: | Frontiers in Immunology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.915590/full |
| _version_ | 1828516254829248512 |
|---|---|
| author | Guanhua Hu Yifei Cheng Yingxi Zuo Yingjun Chang Pan Suo Yueping Jia Aidong Lu Yu Wang Shunchang Jiao Longji Zhang Yuqian Sun Chenhua Yan Lanping Xu Xiaohui Zhang Kaiyan Liu Yu Wang Leping Zhang Xiaojun Huang |
| author_facet | Guanhua Hu Yifei Cheng Yingxi Zuo Yingjun Chang Pan Suo Yueping Jia Aidong Lu Yu Wang Shunchang Jiao Longji Zhang Yuqian Sun Chenhua Yan Lanping Xu Xiaohui Zhang Kaiyan Liu Yu Wang Leping Zhang Xiaojun Huang |
| author_sort | Guanhua Hu |
| collection | DOAJ |
| description | Measurable residual disease (MRD) positivity before haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is an independent prognostic factor in determining outcomes in patients with B-cell acute lymphoblastic leukemia (ALL). In this study, we conducted a parallel comparison of the efficacy and safety in patients with suboptimal MRD response after reinduction who underwent haplo-HSCT after chimeric antigen receptor T-cell (CAR-T) therapy or chemotherapy. Forty B-cell ALL patients who relapsed after first-line chemotherapy and with an MRD ≥0.1% after reinduction were analyzed. The median pre-HSCT MRD in the CAR-T group (n = 26) was significantly lower than that in the chemotherapy group (n = 14) (0.009% vs. 0.3%, p = 0.006). The CAR-T group exhibited a trend toward improved 3-year leukemia-free survival and a significantly improved 3-year overall survival compared to the chemotherapy group [71.8% (95% confidence interval (CI): 53.9–89.6) vs. 44.4% (95% CI: 15.4–73.4), p = 0.19 and 84.6% (95% CI: 70.6–98.5) vs. 40.0% (95% CI: 12.7–67.2), p = 0.008; respectively]. Furthermore, no increased risk of graft-versus-host disease, treatment-related mortality, or infection was observed in the CAR-T group. Our study suggests that CAR-T therapy effectively eliminates pre-HSCT MRD, resulting in better survival in the context of haplo-HSCT. |
| first_indexed | 2024-12-11T18:25:17Z |
| format | Article |
| id | doaj.art-a2af3c1c69eb468d95c1fee20d05f89d |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-12-11T18:25:17Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-a2af3c1c69eb468d95c1fee20d05f89d2022-12-22T00:55:07ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-06-011310.3389/fimmu.2022.915590915590Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided TreatmentGuanhua Hu0Yifei Cheng1Yingxi Zuo2Yingjun Chang3Pan Suo4Yueping Jia5Aidong Lu6Yu Wang7Shunchang Jiao8Longji Zhang9Yuqian Sun10Chenhua Yan11Lanping Xu12Xiaohui Zhang13Kaiyan Liu14Yu Wang15Leping Zhang16Xiaojun Huang17Peking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking-Tsinghua Center for Life Science, Research Unit of Key Technique for Diagnosis and Treatment of Hematologic Malignancies, Chinese Academic of Medical Sciences, Beijing, ChinaPeking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking-Tsinghua Center for Life Science, Research Unit of Key Technique for Diagnosis and Treatment of Hematologic Malignancies, Chinese Academic of Medical Sciences, Beijing, ChinaDepartment of Pediatrics, Peking University People’s Hospital, Peking University, Beijing, ChinaPeking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking-Tsinghua Center for Life Science, Research Unit of Key Technique for Diagnosis and Treatment of Hematologic Malignancies, Chinese Academic of Medical Sciences, Beijing, ChinaPeking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking-Tsinghua Center for Life Science, Research Unit of Key Technique for Diagnosis and Treatment of Hematologic Malignancies, Chinese Academic of Medical Sciences, Beijing, ChinaDepartment of Pediatrics, Peking University People’s Hospital, Peking University, Beijing, ChinaDepartment of Pediatrics, Peking University People’s Hospital, Peking University, Beijing, ChinaDepartment of Immunotherapy, Beijing Yongtai Reike Biotechnology Company Ltd., Beijing, ChinaDepartment of Hematology, Chinese People Liberation Army (PLA) General Hospital, Beijing, ChinaDepartment of Immunotherapy, Shenzhen Geno-immune Medical Institute, Shenzhen, ChinaPeking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking-Tsinghua Center for Life Science, Research Unit of Key Technique for Diagnosis and Treatment of Hematologic Malignancies, Chinese Academic of Medical Sciences, Beijing, ChinaPeking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking-Tsinghua Center for Life Science, Research Unit of Key Technique for Diagnosis and Treatment of Hematologic Malignancies, Chinese Academic of Medical Sciences, Beijing, ChinaPeking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking-Tsinghua Center for Life Science, Research Unit of Key Technique for Diagnosis and Treatment of Hematologic Malignancies, Chinese Academic of Medical Sciences, Beijing, ChinaPeking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking-Tsinghua Center for Life Science, Research Unit of Key Technique for Diagnosis and Treatment of Hematologic Malignancies, Chinese Academic of Medical Sciences, Beijing, ChinaPeking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking-Tsinghua Center for Life Science, Research Unit of Key Technique for Diagnosis and Treatment of Hematologic Malignancies, Chinese Academic of Medical Sciences, Beijing, ChinaPeking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking-Tsinghua Center for Life Science, Research Unit of Key Technique for Diagnosis and Treatment of Hematologic Malignancies, Chinese Academic of Medical Sciences, Beijing, ChinaDepartment of Pediatrics, Peking University People’s Hospital, Peking University, Beijing, ChinaPeking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking-Tsinghua Center for Life Science, Research Unit of Key Technique for Diagnosis and Treatment of Hematologic Malignancies, Chinese Academic of Medical Sciences, Beijing, ChinaMeasurable residual disease (MRD) positivity before haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is an independent prognostic factor in determining outcomes in patients with B-cell acute lymphoblastic leukemia (ALL). In this study, we conducted a parallel comparison of the efficacy and safety in patients with suboptimal MRD response after reinduction who underwent haplo-HSCT after chimeric antigen receptor T-cell (CAR-T) therapy or chemotherapy. Forty B-cell ALL patients who relapsed after first-line chemotherapy and with an MRD ≥0.1% after reinduction were analyzed. The median pre-HSCT MRD in the CAR-T group (n = 26) was significantly lower than that in the chemotherapy group (n = 14) (0.009% vs. 0.3%, p = 0.006). The CAR-T group exhibited a trend toward improved 3-year leukemia-free survival and a significantly improved 3-year overall survival compared to the chemotherapy group [71.8% (95% confidence interval (CI): 53.9–89.6) vs. 44.4% (95% CI: 15.4–73.4), p = 0.19 and 84.6% (95% CI: 70.6–98.5) vs. 40.0% (95% CI: 12.7–67.2), p = 0.008; respectively]. Furthermore, no increased risk of graft-versus-host disease, treatment-related mortality, or infection was observed in the CAR-T group. Our study suggests that CAR-T therapy effectively eliminates pre-HSCT MRD, resulting in better survival in the context of haplo-HSCT.https://www.frontiersin.org/articles/10.3389/fimmu.2022.915590/fullCAR-T therapyB-cell acute lymphoblastic leukemiapediatrichaploidentical hematopoietic stem cell transplantationmeasurable residual disease (MRD) |
| spellingShingle | Guanhua Hu Yifei Cheng Yingxi Zuo Yingjun Chang Pan Suo Yueping Jia Aidong Lu Yu Wang Shunchang Jiao Longji Zhang Yuqian Sun Chenhua Yan Lanping Xu Xiaohui Zhang Kaiyan Liu Yu Wang Leping Zhang Xiaojun Huang Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment Frontiers in Immunology CAR-T therapy B-cell acute lymphoblastic leukemia pediatric haploidentical hematopoietic stem cell transplantation measurable residual disease (MRD) |
| title | Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment |
| title_full | Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment |
| title_fullStr | Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment |
| title_full_unstemmed | Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment |
| title_short | Comparisons of Long-Term Survival and Safety of Haploidentical Hematopoietic Stem Cell Transplantation After CAR-T Cell Therapy or Chemotherapy in Pediatric Patients With First Relapse of B-Cell Acute Lymphoblastic Leukemia Based on MRD-Guided Treatment |
| title_sort | comparisons of long term survival and safety of haploidentical hematopoietic stem cell transplantation after car t cell therapy or chemotherapy in pediatric patients with first relapse of b cell acute lymphoblastic leukemia based on mrd guided treatment |
| topic | CAR-T therapy B-cell acute lymphoblastic leukemia pediatric haploidentical hematopoietic stem cell transplantation measurable residual disease (MRD) |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.915590/full |
| work_keys_str_mv | AT guanhuahu comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT yifeicheng comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT yingxizuo comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT yingjunchang comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT pansuo comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT yuepingjia comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT aidonglu comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT yuwang comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT shunchangjiao comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT longjizhang comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT yuqiansun comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT chenhuayan comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT lanpingxu comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT xiaohuizhang comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT kaiyanliu comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT yuwang comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT lepingzhang comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment AT xiaojunhuang comparisonsoflongtermsurvivalandsafetyofhaploidenticalhematopoieticstemcelltransplantationaftercartcelltherapyorchemotherapyinpediatricpatientswithfirstrelapseofbcellacutelymphoblasticleukemiabasedonmrdguidedtreatment |