CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
TCRαβ 去除造血干细胞移植联合第三方 CD45RA(+) 去除过继细胞治疗移植后细小病毒 B19 再生障碍危象
英文原题：TCRαβ-depleted hematopoietic stem cell transplant and third-party CD45RA(+) depleted adoptive cell therapy for treatment of post-transplant parvovirus B19 aplastic crisis.
查看英文原题
TCRαβ-depleted hematopoietic stem cell transplant and third-party CD45RA(+) depleted adoptive cell therapy for treatment of post-transplant parvovirus B19 aplastic crisis.
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中文摘要
本病例报告介绍一名6岁女孩，患复发性B细胞急性淋巴细胞白血病；过继细胞疗法成功治疗了其难治性人细小病毒B19（HPV B19）感染。患者接受异基因CD19/CD22双特异性嵌合抗原受体（CAR）T细胞治疗，并以父亲半相合供者造血干细胞移植（HSCT）作为桥接治疗。但HPV B19 DNA血症进展，并出现输血相关移植物抗宿主病。找到一名HLA匹配度更高的第三方亲缘供者后，患者接受了半相合、HPV B19血清阳性且去除CD45RA⁺细胞的细胞（16.5×10⁶/kg），随后再次移植去除父源TCR⁺细胞的干细胞。HPV B19 DNA血症在1周内转阴，网织红细胞、中性粒细胞、血红蛋白和血小板计数逐渐恢复正常。患者在门诊随访1年期间保持稳定。本病例提示，持续性B19感染可导致全血细胞减少、再障危象和移植物排斥；去除TCR⁺细胞的半相合移植是恢复造血的有效方法。CD45RO记忆T细胞疗法是治疗和预防难治性重症HPV B19感染的关键。
展开英文摘要原文
This is a case report of a 6-year-old girl with relapsed B cell acute lymphoblastic leukemia in which adoptive cell therapy was applied successfully to treat refractory human parvovirus (HPV) B19 infection. Allogenic chimeric antigen receptor (CAR) T-cell therapy (bispecific CD19/CD22) was bridged to hematopoietic stem cell transplantation (HSCT) using a haploidentical paternal donor.
However, HPV B19 DNAemia progressed and transfusion-related graft versus host disease occurred. After finding a third-party related donor with a better HLA match, haploidentical HPV B19-seropositive CD45RA + depleted cells (16. 5 10 6 /kg) were administered and paternal TCR + depleted stem cell were retransplanted. The HPV B19 DNAemia became negative within 1 week and the reticulocyte, neutrophil, hemoglobin, and platelet counts gradually normalized. The patient remained stable during the 1-year outpatient follow-up period.
Thus, our case report highlights that persistent B19 infection can lead to pancytopenia, aplastic crisis, and graft rejection and TCR + depleted haplo-HSCT is an effective means of hematopoiesis recovery. CD45RO memory T-cell therapy is the key to treating and preventing the development of refractory severe HPV B19 infection.
论文信息
- 作者
- Zhang M、Luo C、Wang J、Zhu H、Luo C、Qin X、Huang X、Lin Y
- 第一作者单位
- Department of Hematology and Oncology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.China
- 通讯作者单位
- Department of Hematology and Oncology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. Electronic address: chenjing@scmc.com.cn.China
- 文献类型
- 病例报告
- 期刊
- International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases2024 Jul
- 原文标识
- PubMed 38583826 · DOI 10.1016/j.ijid.2024.107043