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异基因造血干细胞移植治疗自体 CD7 CAR-T 细胞治疗后达完全缓解的复发/难治性 T 细胞急性淋巴细胞白血病/淋巴母细胞淋巴瘤患者的安全性与疗效研究

英文原题:A safety and efficacy study of allogeneic haematopoietic stem cell transplantation for refractory and relapsed T-cell acute lymphoblastic leukaemia/lymphoblastic lymphoma patients who achieved complete remission after autologous CD7 chimeric antigen receptor T-cell therapy.

PubMed 2024/04/13(内容时间) Br J Haematol Q2 · IF 3.6(JCR 2025)

研究概要

我们的研究表明,CD7 CAR-T 疗法序贯 allo-HSCT 对 r/r T-ALL/LBL 患者不仅有效且安全,其结局也与通过化疗达到 CR 的患者相当,且未增加 NRM。

中文摘要

靶向CD7的CAR-T 细胞治疗难治或复发(r/r)T细胞急性淋巴细胞白血病和淋巴母细胞淋巴瘤(T-ALL/LBL)已显示出良好的初始完全缓解(CR)率。为延长缓解持续时间,研究者考虑以异基因造血干细胞移植(allo-HSCT)进行巩固。本研究分析34例r/r T-ALL/LBL患者在自体CD7 CAR-T治疗达到CR后接受allo-HSCT的结局,并与124例化疗达到CR后接受allo-HSCT的连续患者进行比较。结果显示,CAR-T组和化疗组2年总生存率(OS)相近,分别为61.9%(95% CI 44.1–78.1)和67.6%(95% CI 57.5–76.9;p=0.210);无白血病生存率(LFS)分别为62.3%(95% CI 44.6–78.4)和62.0%(95% CI 51.8–71.7;p=0.548);非复发死亡率(NRM)分别为32.0%(95% CI 19.0–54.0)和25.3%(95% CI 17.9–35.8;p=0.288);复发率分别为8.8%(95% CI 3.0–26.0)和15.8%(95% CI 9.8–25.2;p=0.557)。CD7 CAR-T组中年龄≤14岁的患者2年OS和LFS均较高,达到87.5%。研究提示,CD7 CAR-T后序贯allo-HSCT治疗r/r T-ALL/LBL有效且安全,结局与化疗达到CR后移植的患者相当,且未增加NRM。

展开英文摘要原文

CD7-targeted chimeric antigen receptor T-cell (CAR-T) therapy has shown promising initial complete remission (CR) rates in patients with refractory or relapsed (r/r) T-cell acute lymphoblastic leukaemia and lymphoblastic lymphoma (T-ALL/LBL). To enhance the remission duration, consolidation with allogeneic haematopoietic stem cell transplantation (allo-HSCT) is considered. Our study delved into the outcomes of 34 patients with r/r T-ALL/LBL who underwent allo-HSCT after achieving CR with autologous CD7 CAR-T therapy. These were compared with 124 consecutive T-ALL/LBL patients who received allo-HSCT in CR following chemotherapy. The study revealed that both the CAR-T and chemotherapy cohorts exhibited comparable 2-year overall survival (OS) (61.9% [95% CI, 44.1-78.1] vs. 67.6% [95% CI, 57.5-76.9], p = 0.210), leukaemia-free survival (LFS) (62.3% [95% CI, 44.6-78.4] vs. 62.0% [95% CI, 51.8-71.7], p = 0.548), non-relapse mortality (NRM) rates (32.0% [95% CI, 19.0-54.0] vs. 25.3% [95% CI, 17.9-35.8], p = 0.288) and relapse incidence rates (8.8% [95% CI, 3.0-26.0] vs. 15.8% [95% CI, 9.8-25.2], p = 0.557). Patients aged 14 in the CD7 CAR-T group achieved high 2-year OS and LFS rates of 87.5%. Our study indicates that CD7 CAR-T therapy followed by allo-HSCT is not only effective and safe for r/r T-ALL/LBL patients but also on par with the outcomes of those achieving CR through chemotherapy, without increasing NRM.

论文信息

作者
Cao XY、Zhang JP、Lu Y、Zhao YL、Liu DY、Xiong M、Sun RJ、Wei ZJ
单位
Hebei Yanda Lu Daopei Hospital, Langfang, China.China
期刊
British journal of haematology2024 Jun
原文标识
PubMed 38613241 · DOI 10.1111/bjh.19445