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.
CAR-T（CAR-T）细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
供者来源 CAR-T 治疗造血干细胞移植后复发 B 细胞急性淋巴细胞白血病的疗效与风险
英文原题：Efficacy and risk of donor-derived CAR-T treatment of relapsed B-cell acute lymphoblastic leukemia after hematopoietic stem cell transplantation.
查看英文原题
Efficacy and risk of donor-derived CAR-T treatment of relapsed B-cell acute lymphoblastic leukemia after hematopoietic stem cell transplantation.
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中文摘要
造血干细胞移植（HSCT）后 B 细胞急性淋巴细胞白血病（B-ALL）复发患者的 1 年生存率约为 30%。异基因 HSCT 后复发患者常难以获得自体 CAR-T 产品。
我们研究了本中心 2019 年 8 月至 2023 年 5 月间 14 例 HSCT 后复发 B-ALL 患者接受供者来源 CAR-T 治疗的结局。
结果显示，完全缓解/伴血细胞计数未完全恢复的完全缓解（CR/CRi）率为 78.6%（11/14），GVHD 发生率为 21.4%（3/14），1 年总生存率（OS）为 56%。9 例患者骨髓供者细胞嵌合率下降，CAR-T 治疗后有所恢复。主要死亡原因为疾病进展和感染。
进一步分析显示，GVHD（HR 7.224，95% CI 1.42–36.82，P=0.017）及第 30 天血小板恢复（HR 6.807，95% CI 1.61–28.83，P=0.009）与 CAR-T 治疗后 OS 显著相关。根据研究结果，我们认为供者来源 CAR-T 细胞可有效治疗 HSCT 后复发 B-ALL 患者。
此外，GVHD 和血小板恢复不良会影响 OS，但仍需更大样本量进一步验证。
展开英文摘要原文
The one-year survival rate for patients experiencing a relapse of B-cell acute lymphocytic leukemia (B-ALL) following hematopoietic stem cell transplantation (HSCT) is approximately 30%. Patients experiencing a relapse after allogeneic HSCT frequently encounter difficulties in obtaining autologous CAR-T products.
We conducted a study involving 14 patients who received donor-derived CAR-T therapy for relapsed B-ALL following HSCT between August 2019 and May 2023 in our center. The results revealed a CR/CRi rate of 78. 6% (11/14), a GVHD rate of 21. 4% (3/14), and a 1-year overall survival (OS) rate of 56%. Decreased bone marrow donor cell chimerism in 9 patients recovered after CAR-T therapy. The main causes of death were disease progression and infection.
Further analysis showed that GVHD (HR 7. 224, 95% CI 1. 42-36. 82, P = 0. 017) and platelet recovery at 30 days (HR 6. 807, 95% CI 1. 61-28. 83, P = 0. 009) are significantly associated with OS after CAR-T therapy. Based on the findings, we conclude that donor-derived CAR-T cells are effective in treating relapsed B-ALL patients following HSCT.
Additionally, GVHD and poor platelet recovery impact OS, but further verification with a larger sample size is needed.
论文信息
- 作者
- Deng L、Yu X、Song X、Guan R、Li W、Hou Y、Shao Y、Zhao Y
- 第一作者单位
- Department of Hematology, The 960th Hospital of The Chinese People's Liberation Army Joint Logistics Support Force, Jinan, China.China
- 通讯作者单位
- Department of Hematology, The 960th Hospital of The Chinese People's Liberation Army Joint Logistics Support Force, Jinan, China. Electronic address: zhoufang1@medmail.com.cn.China
- 期刊
- Cytotherapy2024 Nov
- 原文标识
- PubMed 38888526 · DOI 10.1016/j.jcyt.2024.05.021