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:T cell receptor-engineered T cells derived from target human leukocyte antigen-DPB1-specific T cell can be a potential tool for therapy against leukemia relapse following allogeneic hematopoietic cell transplantation.
人类白细胞抗原(HLA)-DPB1抗原在约70%的HLA 10/10相合无关供者异基因造血干细胞移植(allo-HSCT)中存在错配。
人类白细胞抗原(HLA)-DPB1抗原在约70%的来自HLA 10/10相合无关供者的异基因造血干细胞移植(allo-HSCT)中存在错配。HLA-DP错配移植已被证明与急性移植物抗宿主病(GVHD)增加以及由于移植物抗白血病(GVL)效应导致的白血病复发风险降低相关。在非炎症条件下,针对错配HLA-DP的免疫治疗被认为是allo-HCT后治疗白血病的合理方法。因此,我们从健康志愿供者中分离出识别错配HLA-DPB1的CD4+ T细胞克隆,并生成T细胞受体(TCR)基因修饰T细胞以供未来临床应用。对表达候选克隆#17 TCR的TCR-T细胞进行详细分析显示,其对甚至低水平表达靶向HLA-DP的髓系和单核细胞白血病细胞系具有特异性。然而,它们对具有显著水平靶向HLA-DP表达的非造血细胞系无反应,提示该TCR识别的抗原肽仅存在于某些造血细胞中。本研究表明,在采用细致的特异性分析时,诱导针对由造血细胞谱系来源肽组成的HLA-DP特异性T细胞,以及通过基因转移用克隆的TCR cDNA重定向T细胞,是可行的。
Human leukocyte antigen (HLA)-DPB1 antigens are mismatched in approximately 70% of allogeneic hematopoietic stem cell transplantations (allo-HSCT) from HLA 10/10 matched unrelated donors. HLA-DP-mismatched transplantation was shown to be associated with an increase in acute graft-versus-host disease (GVHD) and a decreased risk of leukemia relapse due to the graft-versus-leukemia (GVL) effect. Immunotherapy targeting mismatched HLA-DP is considered reasonable to treat leukemia following allo-HCT if performed under non-inflammatory conditions. Therefore, we isolated CD4 + T cell clones that recognize mismatched HLA-DPB1 from healthy volunteer donors and generated T cell receptor (TCR)-gene-modified T cells for future clinical applications. Detailed analysis of TCR-T cells expressing TCR from candidate clone #17 demonstrated specificity to myeloid and monocytic leukemia cell lines that even expressed low levels of targeted HLA-DP. However, they did not react to non-hematopoietic cell lines with a substantial level of targeted HLA-DP expression, suggesting that the TCR recognized antigenic peptide is only present in some hematopoietic cells. This study demonstrated that induction of T cells specific for HLA-DP, consisting of hematopoietic cell lineage-derived peptide and redirection of T cells with cloned TCR cDNA by gene transfer, is feasible when using careful specificity analysis.
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