决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Case report: The case of T-cell acute lymphoblastic leukemia treated with chemotherapy followed by anti-CD7 CAR-T cells using retroviral vector.
随后,患者维持完全缓解(CR)四个月后复发,嵌合率为26.64%,因此在化疗降低肿瘤负荷后接受了异体抗CD7 CAR-T细胞治疗。
CD7靶向CAR-T(CAR-T)细胞疗法在治疗复发/难治性T细胞急性淋巴细胞白血病(T-ALL)方面显示出巨大前景。在本研究中,我们报道了一例34岁男性T-ALL患者,经过多线高强度化疗后最终出现多线耐药和难治。经医生评估后,该患者接受了异基因造血干细胞移植(allo-HSCT)。随后,患者保持完全缓解(CR)四个月后复发,嵌合率为26.64%,因此在化疗降低肿瘤负荷后接受了异基因抗CD7 CAR-T细胞治疗。CAR-T产品是一种基于逆转录病毒载体(RV)的新型抗CD7 CAR-T。输注后,患者在抗CD7 CAR-T输注后1个月内达到CR,且缓解至今已持续9个月。患者出现细胞因子释放综合征(CRS)1级,未发现免疫效应细胞相关神经毒性综合征(ICANS)。此外,CAR拷贝数在第6天达到峰值350, 758 copies/ g。本病例报告采用未经基因编辑的逆转录病毒载体制备的抗CD7 CAR-T细胞联合化疗治疗T-ALL的临床治疗,表明基于RV的抗CD7 CAR-T细胞在三重难治性T-ALL患者中具有良好的治疗效果和高安全性。
CD7-targeted chimeric antigen receptor-T (CAR-T) cell therapy has shown great promise in the treatment of relapsed/refractory T-cell acute lymphoblastic leukemia (T-ALL). In this study, we reported a case of a 34-year-old male patient with T-ALL who finally developed multi-line drug resistance and refractoriness after multiple lines of high-intensity chemotherapy. After physician evaluation, this patient received allogeneic hematopoietic stem cell transplantation (allo-HSCT). Then, The patient remained in complete remission (CR) for four months before a relapse with 26.64% chimerism rate, so he was treated with allogeneic anti-CD7 CAR-T cells after chemotherapy reducing the tumor burden. The CAR-T product was a novel anti-CD7 CAR-T based on retroviral vectors (RV). After infusion, the patient achieved CR within 1 month after anti-CD7 CAR-T infusion and the remission has been ongoing for 9 months to date. Cytokine release syndrome (CRS) 1 was experienced while no immune effector cell-associated neurotoxicity syndrome (ICANS) was found. In addition, CAR copy number peaked at 350, 758 copies/ g on day 6. This case report of clinical treatment of T-ALL with anti-CD7 CAR-T cells prepared using a retroviral vector without gene editing and combined with chemotherapy, which demonstrated that the RV-based anti-CD7 CAR-T cells had good therapeutic effect and high safety in triple-refractory T-ALL patients.
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