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抗 CD19 嵌合抗原受体 T 细胞治疗复发或难治性 E2A-PBX1 阳性急性淋巴细胞白血病:三例报告。

Anti-CD19 chimeric antigen receptors T cells for the treatment of relapsed or refractory E2A-PBX1 positive acute lymphoblastic leukemia: report of three cases.

机构信息

a Department of Hematology, Jiangsu Institute of Hematology , The First Affiliated Hospital of Soochow University , Suzhou , China.

出版信息

Leuk Lymphoma. 2019 Jun;60(6):1454-1461. doi: 10.1080/10428194.2018.1533127. Epub 2019 Feb 4.

Abstract

Patients with relapsed or refractory E2A-PBX1 positive acute B lymphoblastic leukemia (B-ALL) receiving anti-CD19 chimeric antigen receptor T cells (CAR-T) were retrospectively assessed to evaluate the efficacy and safety of disease burden on outcomes and to identify predictive variables. Of the three case patients, case 1 relapsed after hematopoietic stem cell transplantation. After being treated with anti-CD19 CAR-T, the patient showed minimal residual disease (MRD), and his fusion genes turned negative. Case 2, who suffered refractory leukemia, received anti-CD19 CAR-T treatment in an attempt to remove the MRD before transplantation. She showed MRD, and her fusion genes turned negative. Case 3 received anti-CD19 CAR-T treatment because of relapse after allo-SCT at the molecular level. After infusion, she developed severe pneumonia accompanied with the indication that the leukemia had progressed. Our findings suggest that anti-CD19 CAR-T cells therapy with a remarkable MRD eradicating ability might be an effective option for patients with relapsed and refractory E2A-PBX1 positive B-ALL.

摘要

回顾性评估了接受抗 CD19 嵌合抗原受体 T 细胞(CAR-T)治疗的复发或难治性 E2A-PBX1 阳性急性 B 淋巴细胞白血病(B-ALL)患者,以评估疾病负担对结果的影响,并确定预测变量。在这三个病例患者中,病例 1 在造血干细胞移植后复发。接受抗 CD19 CAR-T 治疗后,患者出现微小残留病(MRD),融合基因转为阴性。病例 2 为难治性白血病,在移植前接受抗 CD19 CAR-T 治疗以试图清除 MRD。她出现了 MRD,融合基因转为阴性。病例 3 因 allo-SCT 后分子水平复发而接受抗 CD19 CAR-T 治疗。输注后,她发生了严重肺炎,且白血病有进展的迹象。我们的研究结果表明,具有显著 MRD 清除能力的抗 CD19 CAR-T 细胞疗法可能是复发和难治性 E2A-PBX1 阳性 B-ALL 患者的有效选择。

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