Josep Carreras Leukemia Research Institute, Barcelona, Spain; Spanish Network for Advanced Therapies, RICORS-TERAV, ISCIII, Spain; PhD programme in Biomedicine, University of Barcelona, Barcelona, Spain.
Josep Carreras Leukemia Research Institute, Barcelona, Spain; PhD programme in Biomedicine, University of Barcelona, Barcelona, Spain.
Cell Rep Med. 2024 Nov 19;5(11):101803. doi: 10.1016/j.xcrm.2024.101803. Epub 2024 Oct 28.
The impact of phenotypic, clonal, and functional heterogeneity of chimeric antigen receptor (CAR)-T cells on clinical outcome remains understudied. Here, we integrate clonal kinetics with transcriptomic heterogeneity resolved by single-cell omics to interrogate cellular dynamics of non-transduced (CAR) and transduced (CAR) T cells, in the infusion product (IP) and at the CAR-T cell expansion peak in five B cell acute lymphoblastic leukemia (B-ALL) patients treated with CD19CAR-T cells (varni-cel). We identify significant differences in cellular dynamics in response to therapy. CAR T cells at IP of complete response patients exhibit a significantly higher CD4:CD8 ratio, validated in a larger cohort B-ALL patients (n = 47). Conversely, at the expansion peak, there is a clonal expansion of CD8 effector memory and cytotoxic T cells. Cytotoxic CAR γδ-T cells expansion correlates with treatment efficacy validated in a cohort of B-ALL (n = 18) and diffuse large B cell lymphoma (DLBCL) patients (n = 58). Our data provide insights into the complexity of T cell responses following CAR-T cell therapy and suggest drivers of immunotherapy response.
嵌合抗原受体 (CAR)-T 细胞表型、克隆和功能异质性对临床结果的影响仍研究不足。在这里,我们整合了克隆动力学与单细胞组学解析的转录组异质性,以研究在输注产品 (IP) 中和在 5 名接受 CD19CAR-T 细胞(varni-cel)治疗的 B 细胞急性淋巴细胞白血病 (B-ALL) 患者的 CAR-T 细胞扩增高峰中,未转导 (CAR) 和转导 (CAR) T 细胞的细胞动力学。我们发现针对治疗的细胞动力学存在显著差异。完全缓解患者的 IP 中的 CAR T 细胞表现出显著更高的 CD4:CD8 比值,在更大的 B-ALL 患者队列 (n=47) 中得到验证。相反,在扩增高峰时,CD8 效应记忆和细胞毒性 T 细胞出现克隆性扩增。细胞毒性 CARγδ-T 细胞的扩增与在 B-ALL 患者队列 (n=18) 和弥漫性大 B 细胞淋巴瘤 (DLBCL) 患者队列 (n=58) 中验证的治疗效果相关。我们的数据提供了对 CAR-T 细胞治疗后 T 细胞反应复杂性的深入了解,并提示了免疫治疗反应的驱动因素。
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