Chimeric antigen receptors T cells in treatment of a relapsed pediatric acute lymphoblastic leukemia, relapse after allogenetic hematopoietic stem cell transplantation: case report and review of literature review.
- Author:
Yingxi ZUO
1
;
Jingbo WANG
;
Aidong LU
;
Yueping JIA
;
Jun WU
;
Lujia DONG
;
Lungji CHANG
;
Leping ZHANG
1
Author Information
- Publication Type:Case Reports
- MeSH: Bone Marrow; Child; Core Binding Factor Alpha 2 Subunit; genetics; Disease-Free Survival; Female; Hematopoietic Stem Cell Transplantation; Humans; Neoplasm, Residual; Oncogene Proteins, Fusion; genetics; Precursor Cell Lymphoblastic Leukemia-Lymphoma; genetics; therapy; Receptors, Antigen, T-Cell; genetics; Recurrence; Remission Induction; T-Lymphocytes; cytology; Transplantation, Homologous
- From: Chinese Journal of Hematology 2016;37(2):115-118
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo evaluate the safety and efficacy of chimeric antigen receptors T cells (CAR-T) in childhood acute B lymphoblastic leukemia (B-ALL).
METHODSA relapsed B-ALL child after allogeneic hematopoietic stem cell transplantation (allo-HSCT) was treated with CAR-T, and the related literatures were reviewed.
RESULTAn 11-year-old girl with TEL-AML1 fusion gene positive BALL who suffered a bone marrow relapse 28 months after remission from conventional chemotherapy. During the second remission, the patient received haploidentical allo-HSCT. She relapsed with detectable TEL-AML1 fusion gene even after chemotherapy and donor leukocyte infusions. She received an experimental donor-derived fourth generation CD19 CAR-T therapy. After infusion of 1 × 10(6)/kg CAR-T cells, she experienced only mild or moderate cytokine-release syndrome and the minimal residual disease turned negative. Then three maintenance of CAR-T cell infusions [(0.83-1.65)×10(6)/kg] was administered, and the disease-free survival had lasted for 10 months. However, the TEL-AML1 copies in her blood still increased and she died with leukemia relapse after additional CAR-T cell infusion.
CONCLUSIONTreatment of relapsed B-ALL with the fourth generation CAR-T cells directed against CD19 was effective and safe. CAR-T therapy is a novel therapeutic approach that could be useful for patients with relapsed and refractory B-ALL who have failed all other treatment options.
