决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:CD7-directed CAR T-cell therapy: a potential immunotherapy strategy for relapsed/refractory acute myeloid leukemia.
自体CD7 CAR-T细胞疗法可被视为治疗CD7表达阳性的AML的一种潜在方法(NCT04762485)。试验注册于Clinical Trials.gov,NCT04762485。
复发/难治性急性髓系白血病(AML)患者通常预后极差,治疗仍具有挑战性。由于CD7在30%的AML中表达,而在正常髓系和红系细胞中不表达,CD7是AML免疫治疗的一个有吸引力的靶点。CD7靶向CAR T细胞在AML异种移植模型中已显示出令人鼓舞的疗效。我们在此报告使用自体CD7 CAR T细胞治疗一例复发/难治性AML患者,该患者具有复杂核型、TP53缺失、FLT3-ITD突变和SKAP2-RUNX1融合基因。在接受CAR T细胞治疗前,患者经IA方案达到部分缓解,再诱导治疗(地西他滨和维奈克拉)后达到完全缓解。巩固治疗(CLAG方案)后出现复发。随后她接受CLIA方案联合维奈克拉治疗失败,并对FLT3抑制剂表现出耐药。骨髓显示20%原始细胞(CD7+ 95.6%)。在地西他滨+FC方案后,给予总剂量为5 10 6/kg的CD7 CAR T细胞。CAR T细胞输注后17天,她达到形态学无白血病状态。患者发生3级细胞因子释放综合征。未观察到严重器官毒性或免疫效应细胞相关神经毒性综合征。总之,自体CD7 CAR T细胞治疗可被视为CD7表达AML的一种潜在治疗方法(NCT04762485)。试验注册 Clinical Trials.gov,NCT04762485。注册于2021年2月21日,前瞻性注册。
Relapsed/refractory acute myeloid leukemia (AML) patients generally have a dismal prognosis and the treatment remains challenging. Due to the expression of CD7 on 30% AML and not on normal myeloid and erythroid cells, CD7 is an attractive target for immunotherapy of AML. CD7-targeted CAR T-cells had demonstrated encouraging efficacy in xenograft models of AML. We report here on the use of autologous CD7 CAR T-cells in the treatment of a relapsed/refractory AML patient with complex karyotype, TP53 deletion, FLT3-ITD mutation, and SKAP2-RUNX1 fusion gene. Before the CAR T-cell therapy, the patient achieved partial remission with IA regimen and attained complete remission after reinduction therapy (decitabine and venentoclax). Relapse occurred after consolidation (CLAG regimen). Then she failed CLIA regimen combined with venetoclax and exhibited resistance to FLT3 inhibitors. Bone marrow showed 20% blasts (CD7+ 95.6%). A total dose of 5 10 6 /kg CD7 CAR T-cells was administered after the decitabine +FC regimen. Seventeen days after CAR T-cells infusion, she achieved morphologic leukemia-free state. The patient developed grade 3 cytokine release syndrome. No severe organ toxicity or immune effector cell-associated neurotoxicity syndrome was observed. In summary, the autologous CD7 CAR T-cell therapy could be considered a potential approach for AML with CD7 expression (NCT04762485).Trial registration Clinical Trials.gov, NCT04762485. Registered on February 21, 2021, prospectively registered.
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