抗 CD22/CD19 CAR-T 细胞疗法 CART2219.1 在成人和儿童复发/难治性 B-ALL 中的 I/II 期试验
A Phase I/II Trial of Anti-CD22/CD19 CAR-T Cell Therapy, CART2219.1, in Adult and Pediatric Relapsed/Refractory B-ALL.
在一项多中心I/II期试验中,所有患者(n=11;7名儿童,4名成人)在第28天均达到完全缓解(91%为微小残留病阴性)。
英文原题:Ex vivo isolation, expansion and bioengineering of CCR7+CD95-/or CD62L+CD45RA+ tumor infiltrating lymphocytes from acute myeloid leukemia patients' bone marrow.
为此,我们首先通过流式细胞术分析了一系列来自AML患者的原发性BM样本(N = 10)的免疫表型。
基于T细胞的免疫疗法可用于急性髓系白血病(AML)。因此,选择最佳T细胞、细胞制备和治疗性T细胞工程对于开发有效的AML过继性T细胞疗法至关重要。自体TIL(肿瘤浸润淋巴细胞)(TILs)已在临床试验中用于治疗实体恶性肿瘤。在此,我们评估了是否可以从AML患者的骨髓(BM)中分离TILs,进行体外扩增,并将其用作AML的新型治疗策略。为此,我们首先通过流式细胞术分析了一系列来自AML患者(N = 10)的原代BM样本的免疫表型。我们观察到BM样本中CD3+ TILs的数量存在差异(范围为单核细胞的2.3-32.6%)。随后,我们开发了一种新方案,可在3、4周内将从AML患者BM(N = 10)和外周血(PB)(N = 10)中分离的TILs,包括从CD3+ T细胞数量较低的患者中分离的TILs,进行三个对数级的体外扩增。此外,我们在AML BM和PB样本中鉴定出了先前描述的na ve T细胞(CCR7+CD95-/或CD62L+CD45RA+),这似乎是成功进行TILs体外扩增所必需的。最后,我们表明扩增后的TILs能够:(1) 在体外对自体AML原始细胞产生细胞毒性(未接受T细胞处理的对照组为90.6%,而接受PB来源T细胞的实验组为1.89%,接受BM来源TILs的实验组为1.77%,p < 0.01),(2) 通过基因工程改造以表达CYP27B1基因,以及 (3) 浸润BM并驻留在已植入免疫缺陷小鼠的预先注射的自体AML原始细胞附近。总之,这些结果为TILs在AML中治疗用途的进一步研究提供了依据。
T cell based immunotherapies can be applicable to acute myeloid leukemia (AML). Therefore, the selection of optimal T cells, cell manufacturing, and therapeutic T cell engineering are essential for the development of effective adoptive T cell therapies for AML. Autologous tumor-infiltrating lymphocytes (TILs) have been in clinical trials to treat solid malignancies. Herein, we assessed whether TILs can be isolated from the bone marrow (BM) of AML patients, expanded ex vivo and utilized as a novel therapeutic strategy for AML. To this end, firstly we analyzed the immunophenotypes of a series of primary BM samples from AML patients (N = 10) by flow cytometry. We observed a variable amount of CD3+ TILs (range 2.3- 32.6% of mononuclear cells) among BM samples. We then developed a novel protocol that produced a three-log ex vivo expansion of TILs isolated from AML patient BM (N = 10) and peripheral blood (PB) (N = 10), including from patients with a low number of CD3+ T cells, within 3, 4 weeks. Further, we identified previously described na ve T cells (CCR7+CD95-/or CD62L+CD45RA+) in AML BM and PB samples, which seemed to be required for a successful TILs ex vivo expansion. Finally, we showed that the expanded TILs could: (1) cause cytotoxicity to autologous AML blasts ex vivo (90.6% in control without T cell treatment vs. 1.89% in experimental groups with PB derived T cells and 1.77% in experimental groups with BM derived TILs, p < 0.01), (2) be genetically engineered to express CYP27B1 gene, and (3) infiltrate the BM and reside in close proximity to pre-injected autologous AML blasts of engrafted immunodeficiency mice. Altogether, these results provide a rationale for further studies of the therapeutic use of TILs in AML.
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