Co-infusion of haplo-identical CD19-chimeric antigen receptor T cells and stem cells achieved full donor engraftment in refractory acute lymphoblastic leukemia.

作者信息

Cai Bo, Guo Mei, Wang Yao, Zhang Yajing, Yang Jun, Guo Yelei, Dai Hanren, Yu Changlin, Sun Qiyun, Qiao Jianhui, Hu Kaixun, Zuo Hongli, Dong Zheng, Zhang Zechuan, Feng Mingxing, Li Bingxia, Sun Yujing, Liu Tieqiang, Liu Zhiqing, Wang Yi, Huang Yajing, Yao Bo, Han Weidong, Ai Huisheng

机构信息

Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.

Department of Immunology/Department of Bio-therapeutic, Institute of Basic Medicine, School of Life Sciences, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.

出版信息

J Hematol Oncol. 2016 Nov 25;9(1):131. doi: 10.1186/s13045-016-0357-z.

DOI:10.1186/s13045-016-0357-z

PMID:27887660

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5124292/

Abstract

BACKGROUND

Elderly patients with relapsed and refractory acute lymphoblastic leukemia (ALL) have poor prognosis. Autologous CD19 chimeric antigen receptor-modified T (CAR-T) cells have potentials to cure patients with B cell ALL; however, safety and efficacy of allogeneic CD19 CAR-T cells are still undetermined.

CASE PRESENTATION

We treated a 71-year-old female with relapsed and refractory ALL who received co-infusion of haplo-identical donor-derived CD19-directed CAR-T cells and mobilized peripheral blood stem cells (PBSC) following induction chemotherapy. Undetectable minimal residual disease by flow cytometry was achieved, and full donor cell engraftment was established. The transient release of cytokines and mild fever were detected. Significantly elevated serum lactate dehydrogenase, alanine transaminase, bilirubin and glutamic-oxalacetic transaminase were observed from days 14 to 18, all of which were reversible after immunosuppressive therapy.

CONCLUSIONS

Our preliminary results suggest that co-infusion of haplo-identical donor-derived CAR-T cells and mobilized PBSCs may induce full donor engraftment in relapsed and refractory ALL including elderly patients, but complications related to donor cell infusions should still be cautioned.