CAR T-cell bridging to allo-HSCT for relapsed/refractory B-cell acute lymphoblastic leukemia: the follow-up outcomes
10.3760/cma.j.issn.0253-2727.2020.09.002
- VernacularTitle:CAR-T细胞桥接异基因造血干细胞移植治疗复发/难治急性B淋巴细胞白血病的临床分析
- Author:
Meng YAN
1
;
Yanjun WU
;
Feng CHEN
;
Xiaowen TANG
;
Yue HAN
;
Huiying QIU
;
Aining SUN
;
Shengli XUE
;
Zhengming JIN
;
Ying WANG
;
Miao MIAO
;
Depei WU
Author Information
1. 苏州大学附属第一医院，江苏省血液研究所，国家血液系统疾病临床医学研究中心，国家卫生健康委员会血栓与止血重点实验室，苏州大学省部共建放射医学与辐射防护国家重点实验室 215123
- Keywords:
Chimeric antigen receptors;
Relapsed;
Refractory;
Leukemia;
Allogeneic hematopoietic stem cell transplantation
- From:
Chinese Journal of Hematology
2020;41(9):710-715
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aims to investigate the efficacy and safety of chimeric antigen receptor (CAR) T-cell bridging allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of recurrent and refractory acute B-lymphocytic leukemia (R/R B-ALL) .Methods:A total of 50 R/R B-ALL patients who underwent CAR T-scell therapy to bridge allo-HSCT in the First Affiliated Hospital of Soochow University from January 2017 to May 2019 were retrospectively analyzed. The overall survival (OS) rate, event-free survival (EFS) rate, cumulative recurrence rate (CIR) , and transplant-related mortality (TRM) of patients with different bone marrow minimal residual disease (MRD) levels were analyzed before and after CAR T-cell infusion and before allo-HSCT.Results:The response rate of CAR T-cell therapy and the incidence rate of severe cytokine release syndrome were 92% and 28% , respectively. During 55 infusions, no treatment-related deaths occurred in any of the patients. The median time of CAR T-cell infusion to allo-HSCT was 54 (26-232) days, the median follow-up time after CAR T-cell infusion was 637 (117-1097) days, and the 1-year OS and EFS rates were (80.0±5.7) % and (60.0±6.9) % . The 1-year CIR and TRM after allo-HSCT were (28.0±0.4) % and (8.0±0.2) % . After CAR T-cell infusion and before allo-HSCT, patients with bone marrow MRD<0.01% had a significantly longer EFS [ (70.0±7.2) % vs (20.0±12.6) % , P<0.001; (66.7±7.5) % vs (36.4±14.5) % , P=0.008]and lower CIR [ (25.0±0.5) % vs (70.0±2.6) % , P<0.001; (23.08±0.47) % vs (45.45±2.60) % , P=0.038]. Conclusion:CAR T-cell therapy bridging allo-HSCT is safe and effective for recurrent and refractory B-ALL.
