Efficacy and safety of chimeric antigen receptor T-cell therapy followed by allogeneic hematopoietic stem cell transplantation in 21 patients with Ph-like acute lymphoblastic leukemia
10.3760/cma.j.cn121090-20230929-00154
- VernacularTitle:嵌合抗原受体T细胞序贯异基因造血干细胞移植治疗Ph样急性淋巴细胞白血病21例的疗效及安全性
- Author:
Haiping DAI
1
;
Hongjie SHEN
;
Zheng LI
;
Wei CUI
;
Qingya CUI
;
Mengyun LI
;
Sifan CHEN
;
Mingqing ZHU
;
Depei WU
;
Xiaowen TANG
Author Information
1. 苏州大学附属第一医院血液内科，国家血液系统疾病临床医学研究中心，江苏省血液研究所，血液学协同创新中心，苏州大学造血干细胞移植研究所，苏州 215006
- Keywords:
Chimeric antigen T cell;
allogenic hematopoietic stem cell transplantation;
Ph-like;
Acute lymphoblastic leukemia
- From:
Chinese Journal of Hematology
2024;45(1):35-40
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of chimeric antigen receptor T-cell (CAR-T) therapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with Ph-like acute lymphoblastic leukemia (Ph-ALL) .Methods:Patients with Ph-ALL who underwent CAR-T therapy followed by allo-HSCT from March 2018 to August 2023 at the First Affiliated Hospital of Soochow University were included, and their clinical data were retrospectively analyzed.Results:Of the 21 patients, 14 were male and 7 were female. The median age at the time of CAR-T therapy was 22 (6-50) years. Seven patients had ABL1-like rearrangements, and 14 had JAK-STAT rearrangements. Prior to CAR-T therapy, 12 patients experienced hematologic relapse; 7 were multiparameter flow cytometry minimal residual disease (MFC-MRD) -positive and 2 were MFC-MRD-negative. CAR-T cells were derived from patients’ autologous lymphocytes. Nine patients were treated with CD19 CAR-T cells, and 12 were treated with CD19/CD22 CAR-T cells. After assessment on day 28 after CAR-T therapy, 95.2% of the patients achieved complete remission, with an MRD-negative remission rate of 75%. Nineteen patients developed grade 0–2 cytokine release syndrome (CRS) and 2 patients suffered grade 3 CRS, all cases of which resolved after treatment. All patients underwent allo-HSCT after CAR-T therapy. The median time from CAR-T therapy to allo-HSCT was 63 (38-114) days. Five patients experienced relapse after CAR-T therapy, including four with hematologic relapse and one with molecular relapse. The 3-year overall survival (OS) rates in the ABL1 and JAK-STAT groups were (83.3±15.2) % and (66.6±17.2) %, respectively ( P=0.68) . The 3-year relapse-free survival (RFS) rates were (50.0±20.4) % and (55.6±15.4) % in the ABL1 and JAK-STAT groups, respectively. There was no significant difference in 3-year OS or RFS between the two groups. Conclusions:CAR-T therapy followed by allo-HSCT leads to rapid remission in most patients with Ph-ALL and prolongs leukemia-free survival.
