Chimeric antigen receptor T-cell therapy for relapsed/refractory acute B-cell lymphoblastic leukemia with T315I mutation: report of one case and review of literature
10.3760/cma.j.cn115356-20190824-00162
- VernacularTitle:嵌合抗原受体T细胞治疗伴T315I突变的复发难治急性B淋巴细胞白血病一例并文献复习
- Author:
Simeng CHEN
1
;
Jiakui ZHANG
;
Yingwei LI
;
Fan WU
;
Qianshan TAO
;
Furun AN
;
Huiping WANG
;
Lingxiao LIU
;
Qing ZHANG
;
Zhimin ZHAI
Author Information
1. 安徽医科大学第二附属医院血液科 生物医疗研究中心 安徽医科大学血液病研究中心，合肥 230601
- From:
Journal of Leukemia & Lymphoma
2020;29(3):170-174
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the safety and efficacy of chimeric antigen receptor T-cell (CAR-T) therapy for relapsed/refractory acute B-cell lymphoblastic leukemia (B-ALL) with T315I mutation.Methods:The clinical data of a patient with relapsed/refractory B-ALL with T315I mutation who underwent CAR-T therapy in the Second Affiliated Hospital of Anhui Medical University was analyzed, and the related literature was reviewed.Results:The patient was a 34-year-old man. He was diagnosed with chronic myelogenous leukemia (CML) in January 2017 and started to take imatinib orally. However, the primary affection transformed to B-ALL 4 months later. Because of the E355G gene mutation, the treatment drug was adjusted to dasatinib, and induction chemotherapy was given at the same time. The sequential consolidation chemotherapy was given for 3 times after complete remission (CR). After half a year of remission, T315I mutation was detected and re-induced chemotherapy was given, but ineffective. The patient was treated with CAR-T 3 days after FC regimen (fludarabine 30 mg/m 2 per day, day 1 to day 3; cyclophosphamide 200 mg/m 2, day 1 to day 3). The number of CD19 CAR-T was 1.0×10 9, 98% activity degree. Grade 1 cytokine-releasing syndrome appeared after infusion, and was resolved after symptomatic treatment. No serious adverse reactions were observed. CR was achieved half-month after CAR-T treatment, and umbilical cord blood transplantation was successfully performed 1 month later. At the last follow-up, the relapse-free survival time of the patient was 396 days. Conclusion:CAR-T therapy may be a new, safe and effective therapy for patients with relapsed/refractory B-ALL with T315I mutation.
