The evaluation of modified cell infusion method to reduce febrile non-hemolytic transfusion reaction in CD19 chimeric antigen receptor T cell threapy
10.3760/cma.j.issn.0578-1426.2019.09.007
- VernacularTitle: 改良细胞输注法降低CD19嵌合抗原受体T细胞治疗相关发热非溶血性输血反应临床观察
- Author:
Jia WANG
1
;
Qi DENG
;
Juan MU
;
Yanyu JIANG
;
Juanxia MENG
;
Yuming LI
Author Information
1. Department of Hematology, Tianjin First Central Hospital, Tianjin 300192, China
- Publication Type:Journal Article
- Keywords:
Chimeric antigen receptor -T cells;
Albumin;
Febrile non-hemolytic transfusion reaction
- From:
Chinese Journal of Internal Medicine
2019;58(9):668-672
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To retrospectively analyze the efficacy and safety of modified cell infusion method in reducing the incidence of febrile non-hemolytic transfusion reaction (FNHTR).
Methods:A total of 69 patients were enrolled in the clinical trial of CD19 chimeric antigen receptor T (CAR-T) cell treatment from February 2017 to October 2018. Study group received the modified cell infusion method, that 1×106 CAR-T cells were re-suspended in 2 mg human serum albumin with total volume of 20 ml and injected intravenously. The control group was intravenously administrated with CAR-T cell in 100 ml normal saline. The incidence of FNHTR, cytokine releasing syndrome (CRS) grade, cytokine level and efficacy were compared.
Results:(1)The incidence of FNHTR in the study group was 21.1%, significantly lower than that in the control group (71%)(P=0.000). (2)There was no statistical difference in cell proliferation between the study group and the control group on day 4, 7, 14 and 21 after CAR-T cell infusion (P=10.223, 3.254, 5.551, 7.605). (3)There was no statistical difference in CRS grading between the study group and the control group (P=0.767). There was no statistical difference in the levels of interleukin 2 receptor (IL-2R), IL-6, tumor necrosis factor (TNF)-α between the two groups. (4)The C-reaction protein (CRP) level of the study group was lower than that of the control group on day 4 and 7 (P=0.026, 0.007). (5)There was no statistical difference of response rates in acute lymphocytic leukemia (ALL) and non-Hodgkin lymphoma (NHL) patients between the two groups (PALL=0.842; PNHL=0.866).
Conclusion:The modified cell infusion method in CD19 CAR-T cell treatment reduces the incidence of treatment-related FNHTR. It does not affect the proliferation of CAR-T cells in vivo, the grading of CRS and the response rates.
