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PD-1 敲低 CLL-1 CAR-T 疗法在 2 例移植后复发且抗 CD38 CAR-T 细胞治疗失败的 AML 患者中的成功应用

英文原题:Successful application of PD-1 knockdown CLL-1 CAR-T therapy in two AML patients with post-transplant relapse and failure of anti-CD38 CAR-T cell treatment.

PubMed 2022/02/15(内容时间) Am J Cancer Res Q2 · IF 3.1(JCR 2025)

研究概要

在末次随访时,病例 1 和病例 2 分别维持持续缓解 8 个月和 3 个月。

中文摘要

复发/难治性急性髓系白血病(R/R AML)患者常对化疗耐药,预后极差,因此亟需开发新的治疗策略。CAR-T 细胞疗法在B细胞恶性肿瘤治疗中取得巨大进展,推动了许多针对R/R AML开发CAR-T疗法的工作,但成功有限,部分原因是缺乏特异性靶点。C型凝集素样分子1(CLL-1)在AML原始细胞上高表达,而正常造血干细胞上不表达,因此是AML免疫治疗的理想靶点。我们报告2例异基因干细胞移植后复发、且包括抗CD38 CAR-T治疗在内的多线挽救治疗失败的R/R AML患者;两例均成功接受PD-1沉默的抗CLL-1 CAR-T治疗。在输注CLL-1 CAR-T细胞后第28天评估时,两例患者均达到分子学完全缓解,但血液学恢复不完全。病例1和病例2分别发生1级和2级细胞因子释放综合征。末次随访时,两例患者分别已持续缓解8个月和3个月。结果表明,CLL-1 CAR-T细胞可能是移植后复发AML患者有效且安全的挽救治疗。

展开英文摘要原文

Patients with relapsed/refractory acute myeloid leukemia (R/R AML) often show resistance to chemotherapy and have dismal outcomes. Therefore, it is urgent to develop new treatment strategies to address this problem. With tremendous achievement of chimeric antigen receptor T cells (CAR-T) therapy against B-cell malignancies, many efforts have been devoted to developing CAR-T therapy for R/R AML but with limited success, in part owing to a lack of specific targets. C-type lectin-like molecule-1 (CLL-1) is highly expressed on AML blasts with no expression on normal hematopoietic stem cells, which makes it an ideal target of immunotherapy for AML. Here, we report 2 R/R AML patients who relapsed after allogeneic stem cell transplantation and failed multiline salvage therapies including anti-CD38 CAR-T therapy, but were successfully treated with PD-1 silenced anti-CLL-1 CAR-T therapy. Both patients achieved molecular complete remission with incomplete hematologic recovery at 28 days of evaluation after CLL-1 CAR-T cell infusion. Cytokine release syndrome in cases 1 and 2 were grade 1 and 2, respectively. At the last follow-up, cases 1 and 2 had maintained continuous remission for 8 and 3 months, respectively. Our results demonstrated that CLL-1 CAR-T cells might be an effective and safe salvage therapy for AML patients with posttransplant relapse.

论文信息

作者
Ma YJ、Dai HP、Cui QY、Cui W、Zhu WJ、Qu CJ、Kang LQ、Zhu MQ
单位
National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu, China.China
期刊
American journal of cancer research2022
原文标识
PubMed 35261791