CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Demethylating agents in combination with CD7-targeted CAR-T for the successful treatment of a case with mixed-phenotype acute leukemia relapsed after allogeneic hematopoietic stem cell transplantation: A Case Report.
Demethylating agents in combination with CD7-targeted CAR-T for the successful treatment of a case with mixed-phenotype acute leukemia relapsed after allogeneic hematopoietic stem cell transplantation: A Case Report.
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去甲基化药物联合 CD7 靶向 CAR-T 细胞疗法治疗移植后复发的 MPAL 患者是可行的,且具有良好的疗效和安全性,将成为 MPAL 一种有前景的治疗选择。
异基因造血干细胞移植(allo-HSCT)已治愈许多恶性血液病患者,包括混合表型急性白血病(MPAL);但移植后复发患者死亡率仍高、预后差,且缺乏标准治疗。因此,有必要探索更多治疗方法以改善移植后复发患者的结局。病例介绍:一名年轻男性MPAL患者经诱导化疗达到完全缓解(CR)后接受allo-HSCT。不幸的是,9个月后髓系和T细胞谱系均复发。接受去甲基化治疗后,髓系谱系可测量残留病(MRD)转阴;接受靶向CD7的嵌合抗原受体(CAR)T细胞治疗后,T细胞谱系MRD也转阴。骨髓MRD阴性状态维持了4个月。本病例初步显示,靶向CD7的CAR-T 可诱导持久CR并改善预后。
去甲基化药物联合靶向CD7的CAR-T 治疗移植后复发MPAL具有可行性,且疗效和安全性良好,有望成为MPAL的治疗选择。
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has cured many patients with malignant hematologic diseases such as mixed phenotype acute leukemia (MPAL), while those relapsing after allo-HSCT still exhibit high mortality, poor prognosis, and no standard treatment modalities. It is necessary to explore more therapeutic modalities for patients with post-transplant relapse to obtain a better prognosis. CASE PRESENTATION: In this case report, a young male with MPAL received allo-HSCT after reaching complete remission (CR) by induction chemotherapy. Unfortunately, relapse of both myeloid and T lineages occurred nine months later. After receiving demethylating chemotherapy, myeloid lineage measurable residual disease (MRD) turned negative. T-lineage MRD turned negative after CD7-targeted chimeric antigen receptor (CAR)-T cell therapy. The bone marrow remained MRD-negative for 4 months. This case preliminarily demonstrated a long-lasting CR with CD7-targeted CAR-T cell therapy, allowing a better prognosis.
Demethylating drugs combined with CD7-targeted CAR-T cell therapy is feasible in treating MPAL patients with relapse after transplantation, with good efficacy and safety, which will be a promising treatment option for MPAL.
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