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复发/难治性急性淋巴细胞白血病儿童接受 inotuzumab ozogamicin 治疗后 CAR-T 细胞治疗的结局

英文原题:Outcome of chimeric antigen receptor T-cell therapy following treatment with inotuzumab ozogamicin in children with relapsed or refractory acute lymphoblastic leukemia.

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Outcome of chimeric antigen receptor T-cell therapy following treatment with inotuzumab ozogamicin in children with relapsed or refractory acute lymphoblastic leukemia.

PubMed 2022/10/30(内容时间) Leukemia Q1 · IF 8.8(JCR 2025)

研究概要

在这项国际性回顾性分析中,分析了39名儿童和年轻成人,他们在T细胞采集前(n = 12)和/或后(n = 27)接受InO作为CART-19治疗的桥接治疗。

中文摘要

靶向CD19的CAR-T 细胞(CART-19)对复发/难治性(R/R)B细胞前体急性淋巴细胞白血病(BCP-ALL)显示出显著疗效。我们研究了先前使用inotuzumab ozogamicin(InO)——一种与calicheamicin偶联的抗CD22抗体——是否可能通过CART-19治疗前对B细胞区域的清除而影响CAR T细胞的制备或疗效。在这项国际性回顾性分析中,分析了39例在T细胞采集前(n = 12)和/或后(n = 27)接受InO作为CART-19治疗桥接治疗的儿童和年轻成人。输注时的中位年龄为13岁(范围1.4-23岁)。39例患者中有34例(87.2%)获得完全缓解。CART-19输注后中位随访18.2个月,12个月无事件生存(EFS)率为53.3%(95%置信区间(CI):38.7-73.4),总生存(OS)率为77.8%(95% CI:64.5-93.9)。17例患者(44%)复发,中位时间为CART-19输注后159天(范围28-655)。在采集前或后接受InO的患者之间,第28天微小残留病阴性完全缓解率、12个月OS/EFS或CD19阳性或阴性复发发生率均无差异。与未先前暴露于InO而接受CART-19治疗的患者已发表数据相比,在CART-19前接受InO治疗的患者其缓解率和OS/EFS相似。

展开英文摘要原文

Chimeric antigen receptor T cells targeting CD19 (CART-19) have shown remarkable efficacy for relapsed/refractory (R/R) B-cell precursor acute lymphoblastic leukemia (BCP-ALL). We investigated whether prior use of inotuzumab ozogamicin (InO), an anti-CD22 antibody conjugated to calicheamicin, may impact CAR T-cell manufacturing or efficacy via pre-CART-19 depletion of the B-cell compartment. In this international, retrospective analysis, 39 children and young adults receiving InO before (n = 12) and/or after (n = 27) T-cell apheresis as bridging therapy to CART-19 treatment were analyzed. Median age at infusion was 13 years (range 1.4-23 years). Thirty-four out of 39 patients (87.2%) obtained complete remission. With a median follow-up of 18.2 months after CART-19 infusion, 12-month event-free survival (EFS) was 53.3% (95% confidence interval (CI): 38.7-73.4) and overall survival (OS) was 77.8% (95% CI: 64.5-93.9). Seventeen patients (44%) relapsed with a median of 159 days (range 28-655) after CART-19 infusion. No difference in day 28 minimal residual disease negative complete response rate, 12-month OS/EFS, or incidence of CD19-positive or -negative relapses was observed among patients receiving InO before or after apheresis. Compared to published data for patients treated with CART-19 therapy without prior InO exposure, response and OS/EFS for patients treated with InO prior to CART-19 are similar.

论文信息

作者
Ceolin V、Brivio E、van Tinteren H、Rheingold SR、Leahy A、Vormoor B、O'Brien MM、Rubinstein JD
第一作者单位
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.Netherlands
通讯作者单位
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands. c.m.zwaan@prinsesmaximacentrum.nl.Netherlands
期刊
Leukemia2023 Jan
原文标识
PubMed 36310183 · DOI 10.1038/s41375-022-01740-9