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供者来源的抗白血病细胞毒性T淋巴细胞预防儿童单倍体造血干细胞移植后白血病复发的安全性及初步疗效的I/II期临床试验:研究原理与设计

Phase I/II clinical trial on the safety and preliminary efficacy of donor-derived anti-leukemia cytotoxic T lymphocytes for the prevention of leukemia relapse in children given haploidentical hematopoietic stem cell transplantation: study rational and design.

作者信息

Montagna Daniela, Comoli Patrizia, Tanzi Matteo, Montini Enrica, Moretta Antonia, Taurino Gloria, Boghen Stella, Panigari Arianna, Mina Tommaso, Giorgiani Giovanna, Del Fante Claudia, Perotti Cesare, Zecca Marco

机构信息

Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

出版信息

Front Immunol. 2025 Jun 6;16:1601961. doi: 10.3389/fimmu.2025.1601961. eCollection 2025.


DOI:10.3389/fimmu.2025.1601961
PMID:40547030
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12178864/
Abstract

UNLABELLED: Leuk-CTL-001 (EudraCT n. 2019-003362-41) is a Phase I/II clinical trial on the safety and preliminary efficacy of donor-derived anti-leukemia cytotoxic T lymphocytes (CTLs) for the prevention of leukemia relapse in children given haploidentical hematopoietic stem cell transplantation (HCT). The prognosis for children affected by acute leukemia and transplanted in an advanced disease stage, in the presence of measurable minimal residual disease (MRD) or with unfavorable cytogenetic abnormalities, is still poor and often less than 50%. Adoptive cell therapy based on the infusion of donor-derived CTLs able to recognize patients' leukemia blasts (LB) is a promising approach to control leukemia relapse after allogeneic HCT. We previously described a procedure for generating and expanding large numbers of donor-derived anti-leukemia CTL in compliance with Good Manufacturing Practice (GMP). The analysis of all batches of anti-leukemia CTLs produced so far documented that the majority of effector cells were CD3+/CD8+ cells, with a memory/terminal activated phenotype displaying efficient capacity to lyse patients' LB and to secrete IFNγ and TNFα in response to leukemia cells. The Leuk-001 trial explores the safety of infusion of escalating doses of anti-leukemia CTLs in a cohort of high-risk relapse pediatric patients given haploidentical HCT for acute leukemia, starting within 60 days after transplantation. The safety is evaluated in terms of incidence of acute and chronic graft versus host disease (GVHD). The secondary objective is the evaluation of efficacy defined as cumulative incidence of relapse. CLINICAL TRIAL REGISTRATION: https://www.isrctn.com/, identifier ISRCTN13301166; https://clinicaltrials.gov/, NCT06865352.

摘要

未标注:Leuk-CTL-001(欧洲临床试验注册号:2019-003362-41)是一项I/II期临床试验,旨在研究供体来源的抗白血病细胞毒性T淋巴细胞(CTL)预防接受单倍体造血干细胞移植(HCT)的儿童白血病复发的安全性和初步疗效。对于患有急性白血病且在疾病晚期进行移植、存在可测量的微小残留病(MRD)或伴有不良细胞遗传学异常的儿童,其预后仍然很差,生存率通常低于50%。基于输注能够识别患者白血病原始细胞(LB)的供体来源CTL的过继性细胞疗法是控制异基因HCT后白血病复发的一种有前景的方法。我们之前描述了一种符合药品生产质量管理规范(GMP)的大量生产和扩增供体来源抗白血病CTL的程序。对迄今为止生产的所有批次抗白血病CTL的分析表明,大多数效应细胞是CD3+/CD8+细胞,具有记忆/终末活化表型,对裂解患者的LB以及响应白血病细胞分泌IFNγ和TNFα具有高效能力。Leuk-001试验探索在一组接受单倍体HCT治疗急性白血病的高危复发儿科患者中,在移植后60天内开始输注递增剂量抗白血病CTL的安全性。安全性通过急性和慢性移植物抗宿主病(GVHD)的发生率进行评估。次要目标是评估定义为复发累积发生率的疗效。 临床试验注册:https://www.isrctn.com/,标识符ISRCTN13301166;https://clinicaltrials.gov/,NCT06865352。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3afc/12178864/d582840ead2b/fimmu-16-1601961-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3afc/12178864/aef23b5f0c85/fimmu-16-1601961-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3afc/12178864/d582840ead2b/fimmu-16-1601961-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3afc/12178864/aef23b5f0c85/fimmu-16-1601961-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3afc/12178864/d582840ead2b/fimmu-16-1601961-g002.jpg

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[1]
Phase I/II clinical trial on the safety and preliminary efficacy of donor-derived anti-leukemia cytotoxic T lymphocytes for the prevention of leukemia relapse in children given haploidentical hematopoietic stem cell transplantation: study rational and design.

Front Immunol. 2025-6-6

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本文引用的文献

[1]
Novel CD62L depleted donor lymphocyte infusion with T-cell receptor alpha-beta depleted haploidentical hematopoietic stem cell transplantation in children.

Transpl Immunol. 2025-3

[2]
Production of donor-derived cytotoxic T lymphocytes with potent anti-leukemia activity for adoptive immunotherapy in high-risk pediatric patients given haploidentical hematopoietic stem cell transplantation.

Cytotherapy. 2024-8

[3]
Allogeneic CAR-T Therapy Technologies: Has the Promise Been Met?

Cells. 2024-1-12

[4]
TCRαβ/CD19 cell-depleted HLA-haploidentical transplantation to treat pediatric acute leukemia: updated final analysis.

Blood. 2024-1-18

[5]
Practical aspects of chimeric antigen receptor T-cell administration: From commercial to point-of-care manufacturing.

Front Immunol. 2022

[6]
A Review of Clinical Outcomes of CAR T-Cell Therapies for B-Acute Lymphoblastic Leukemia.

Int J Mol Sci. 2021-2-21

[7]
Safety and efficacy of the low-dose memory (CD45RA-depleted) donor lymphocyte infusion in recipients of αβ T cell-depleted haploidentical grafts: results of a prospective randomized trial in high-risk childhood leukemia.

Bone Marrow Transplant. 2021-7

[8]
Unrelated donor vs HLA-haploidentical α/β T-cell- and B-cell-depleted HSCT in children with acute leukemia.

Blood. 2018-10-22

[9]
Is the use of unrelated donor transplantation leveling off in Europe? The 2016 European Society for Blood and Marrow Transplant activity survey report.

Bone Marrow Transplant. 2018-3-14

[10]
Tisagenlecleucel in Children and Young Adults with B-Cell Lymphoblastic Leukemia.

N Engl J Med. 2018-2-1

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