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:Development of TCR-T cell therapy targeting mismatched HLA-DPB1 for relapsed leukemia after allogeneic transplantation.
人类白细胞抗原(HLA)-DPB1错配在约70%的无关供者allo-HSCT病例中发生,如果在适当条件下进行,针对错配的HLA-DPB1治疗allo-HSCT后复发的白血病被认为是合理的。
异基因造血干细胞移植(allo-HSCT)后白血病复发仍然是一项重大挑战,原发病再度出现是最常见的死亡原因。人类白细胞抗原(HLA)-DPB1错配约发生于70%的无关供者allo-HSCT病例中,如果在适当条件下进行,靶向错配的HLA-DPB1被认为是治疗allo-HSCT后复发白血病的合理策略。在本研究中,我们从三名接受HLA-DPB1错配allo-HSCT的患者中,利用移植后患者体内针对错配HLA-DPB1致敏的供者来源同种反应性T细胞,建立了若干限制性识别HLA-DPB1*02:01、-DPB1*04:02和-DPB1*09:01的克隆。对DPB1*09:01限制性克隆2A9的详细分析显示,其对各种白血病细胞系和原发性髓系白血病原始细胞均具有反应性,即使在HLA-DP低表达的情况下也是如此。来源于克隆2A9的T细胞受体(TCR)-T细胞在体外保留了触发HLA-DPB1*09:01限制性识别并裂解多种白血病细胞系的能力。我们的研究表明,从allo-HSCT后生理性致敏的同种反应性CD4+ T细胞中诱导错配HLA-DPB1特异性T细胞克隆,以及通过基因转移用克隆的TCR cDNA重定向T细胞,作为未来过继性免疫治疗的技术是可行的。
Relapsed leukemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains a significant challenge, with the re-emergence of the primary disease being the most frequent cause of death. Human leukocyte antigen (HLA)-DPB1 mismatch occurs in approximately 70% of unrelated allo-HSCT cases, and targeting mismatched HLA-DPB1 is considered reasonable for treating relapsed leukemia following allo-HSCT if performed under proper conditions. In this study, we established several clones restricted to HLA-DPB1*02:01, -DPB1*04:02, and -DPB1*09:01 from three patients who underwent HLA-DPB1 mismatched allo-HSCT using donor-derived alloreactive T cells primed to mismatched HLA-DPB1 in the recipient's body after transplantation. A detailed analysis of the DPB1*09:01-restricted clone 2A9 showed reactivity against various leukemia cell lines and primary myeloid leukemia blasts, even with low HLA-DP expression. T cell receptor (TCR)-T cells derived from clone 2A9 retained the ability to trigger HLA-DPB1*09:01-restricted recognition and lysis of various leukemia cell lines in vitro. Our study demonstrated that the induction of mismatched HLA-DPB1 specific T cell clones from physiologically primed post-allo-HSCT alloreactive CD4 + T cells and the redirection of T cells with cloned TCR cDNA by gene transfer are feasible as techniques for future adoptive immunotherapy.
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