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去甲基化药物联合 CD7 靶向 CAR-T 成功治疗异基因造血干细胞移植后复发的混合表型急性白血病一例:病例报告

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.

查看英文原题

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.

PubMed 2023/09/28(内容时间) Front Immunol Q1 · IF 7(JCR 2025)

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研究概要

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。

中文摘要

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。

展开英文摘要原文

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.

论文信息

作者
Han Y、Yao H、He GC、Lai SH、Deng Y、Zhang S、He Y、Xiong YS
单位
Department of Hematology, The General Hospital of Western Theater Command, PLA, Chengdu, China.China
文献类型
病例报告 · 非美国政府资助研究
期刊
Frontiers in immunology2023
原文标识
PubMed 37841245 · DOI 10.3389/fimmu.2023.1254010