Bone Marrow Transplantation, Beijing Boren Hospital, Beijing, China.
Front Immunol. 2022 Jul 12;13:931452. doi: 10.3389/fimmu.2022.931452. eCollection 2022.
The use of chimeric antigen receptor T cells (CAR-Ts) is effective in the treatment of hematological malignancies. It has been reported that HBV is reactivated after CAR-T immunotherapy for refractory/relapsed hematological malignant B-cell tumors. However, there is little literature on donor-derived CAR-T therapy combined with allogeneic hematopoietic stem cell transplantation in hepatitis B patients with acute T-lymphocytic leukemia. We report the case of one patient with hepatitis B associated with relapsed/refractory acute T-lymphocytic leukemia (T-ALL) treated with donor-derived CD7 CAR-T therapy and allogeneic hematopoietic stem cell transplantation. During treatment, the copy number of hepatitis B virus continuously decreased, and AST, ALT, DBIL and TBIL remained within the controllable ranges. CD7-negative MRD recurred 4.5 months after transplantation, and the flow cytometry results became negative after immunosuppressive reduction. Seven months after transplantation, the patient had complete remission, and the copy number of hepatitis B virus decreased to below 10. This is the first study on the safety and effectiveness of donor-derived CD7 CAR-T therapy bridging to allogeneic hematopoietic stem cell transplantation in a patient with relapsed/refractory acute T-lymphocytic leukemia and hepatitis B.
嵌合抗原受体 T 细胞（CAR-Ts）的应用在血液系统恶性肿瘤的治疗中是有效的。据报道，在 CAR-T 免疫治疗难治/复发血液恶性 B 细胞肿瘤后，HBV 会被重新激活。然而，关于乙型肝炎患者接受供体来源的 CAR-T 治疗联合异基因造血干细胞移植治疗急性 T 淋巴细胞白血病的文献很少。我们报告了一例乙型肝炎相关的复发/难治性急性 T 淋巴细胞白血病（T-ALL）患者，接受了供体来源的 CD7 CAR-T 治疗和异基因造血干细胞移植。在治疗过程中，乙肝病毒的拷贝数持续下降，AST、ALT、DBIL 和 TBIL 均在可控制范围内。移植后 4.5 个月出现 CD7 阴性 MRD 复发，经免疫抑制减少后流式细胞学结果转为阴性。移植后 7 个月，患者完全缓解，乙肝病毒拷贝数降至 10 以下。这是首例关于供体来源的 CD7 CAR-T 治疗桥接乙型肝炎复发/难治性急性 T 淋巴细胞白血病患者异基因造血干细胞移植的安全性和有效性的研究。
