Control effect of Dasatinib on the treatment of acute myeloid leukemia and adverse events of CD123 targeting CAR-T:a case report and literature review
10.16016/j.2097-0927.202310049
- VernacularTitle:达沙替尼对靶向CD123的CAR-T治疗AML及不良反应的控制作用1例报告及文献复习
- Author:
Chunmin LI
1
,
2
;
Yu LI
;
Zhongtao YUAN
;
Lin LIU
;
Le LUO
;
Xiaoping LI
;
Sanbin WANG
;
Shiqi LI
Author Information
1. 650100 昆明,中国人民解放军联勤保障部队第九二○医院血液科
2. 650500 昆明,昆明医科大学研究生院
- Keywords:
chimeric antigen receptor T cells;
acute myeloid leukemia;
CD123 antigen;
dashatinib;
cytokine release syndrome
- From:
Journal of Army Medical University
2024;46(4):347-351
- CountryChina
- Language:Chinese
-
Abstract:
Objective To preliminarily explore the efficacy of chimeric antigen receptor T cells(CAR-T)targeting CD 123 in the treatment of acute myeloid leukemia(AML)and the role of dasatinib in the treatment of CD123 targeting CAR-T induced side effects.Methods Clinical data of 1 patient with relapsed AML admitted to No.920 Hospital of PLA Joint Logistic Support Force in September,2019 were collected.The patient relapsed after previous multi-line chemotherapy and was treated with CD123 targeting CAR-T therapy.The routine blood changes of the patient after treatment were observed.Dasatinib was used when agranulocytosis occurred,40 mg orally 3 times per day,and was stopped when agranulocytosis was relieved.Changes in blood cells,CAR-T amplification,and disease control were observed.The patient was followed up for over 1 year.Results Flow cytometry for bone marrow showed that minimal residual disease negative result was observed in 30 d after infusion.The patient remained disease-free for over 1 year.After CD 123 CAR-T cells infusion,significant expansion of CAR-T cells was observed,accompanied by granulocyte deficiency and cytokine release syndrome(CRS).After using dasatinib,inhibition of CAR-T cell expansion was observed,accompanied by blood cell recovery,and CRS symptoms were alleviated.After stop of dasatinib,CAR-T cells expanded again and blood cells decreased again.Conclusion CAR-T cells targeting CD 123 have certain efficacy in the treatment for relapsed AML.Dashatinib has a blocking effect on the amplification and function of CAR-T,which can alleviate bone marrow suppression caused by CD 123 targeting CAR-T and avoid severe CRS.
