Xu Guo-Fa, Liu Li-Min, Wang Man, Zhang Zhi-Bo, Xie Jun-Dan, Qiu Hui-Ying, Chen Su-Ning
Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Collaborative Innovation Center of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Soochow University, Suzhou, P.R. China.
Department of Hematology, Chongqing University FuLing Hospital, Chongqing, P.R. China.
Leuk Lymphoma. 2022 Nov;63(11):2652-2662. doi: 10.1080/10428194.2022.2090550. Epub 2022 Jun 24.
Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL) is a high-risk subtype of ALL. We retrospectively studied 70 cases with Ph-like ALL and here present the largest study of CAR-T cell treatment and haplo-HSCT for this leukemia. Median age was 26 years and median leukocyte count was 31.44 × 10/L. The proportion of patients receiving chemotherapy, KIs, CAR-T cells, and allo-HSCT was 19%, 30%, 46%, and 61%, respectively. The overall response rate was 62%, 73%, and 100% after one month of KI treatment combined with chemotherapy, CAR-T cell therapy, and allo-HSCT, respectively. Five-year DFS and OS were 35% and 51%, respectively. The five-year cumulative incidence of relapse and non-relapse mortality was 63% and 11%, respectively. Allo-HSCT was associated with a better DFS ( = 0.010) and OS ( = 0.000) by univariate analysis. In conclusion, allo-HSCT after KIs together with chemotherapy or CAR-T cell therapy is a safe and feasible treatment modality for Ph-like ALL.
费城染色体样急性淋巴细胞白血病（Ph样ALL）是ALL的一种高危亚型。我们回顾性研究了70例Ph样ALL患者，在此展示了针对该白血病的最大规模的CAR-T细胞治疗和单倍体造血干细胞移植（haplo-HSCT）研究。中位年龄为26岁，中位白细胞计数为31.44×10⁹/L。接受化疗、激酶抑制剂（KIs）、CAR-T细胞和异基因造血干细胞移植的患者比例分别为19%、30%、46%和61%。在KI治疗联合化疗、CAR-T细胞治疗和异基因造血干细胞移植后1个月，总体缓解率分别为62%、73%和100%。五年无病生存率（DFS）和总生存率（OS）分别为35%和51%。五年复发和非复发死亡率的累积发生率分别为63%和11%。单因素分析显示，异基因造血干细胞移植与更好的DFS（P = 0.010）和OS（P = 0.000）相关。总之，在KI联合化疗或CAR-T细胞治疗后进行异基因造血干细胞移植是治疗Ph样ALL的一种安全可行的治疗方式。
