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:Minimal residual disease assessment following CD19-targeted therapy in B-cell precursor acute lymphoblastic leukemia using standardized 12-color flow cytometry: A EuroFlow study.
我们的研究结果表明,12 色 panel 与 8 色 BCP-ALL MRD panel 表现相当,涵盖 CD19 阳性和 CD19 阴性病例。
检测微小/可测量残留病(MRD)是B细胞前体急性淋巴细胞白血病(BCP-ALL)的关键预后指标。EuroFlow联盟此前开发了8色流式细胞术MRD检测方案,对接受化疗的98%以上BCP-ALL患者有效。本研究旨在将EuroFlow方案扩展至12色,提高MRD检测能力,尤其适用于接受CD19靶向治疗的患者。新方案增加了B细胞标志物以及用于排除T/NK细胞的标志物CD3和CD7。研究评估237份初诊BCP-ALL样本后,选定CD22、CD24和HLA-DR作为额外的B细胞设门标志物。研究者对两管12色方案进行了技术优化,并在101份患者随访样本中完成临床验证;结果与分子MRD水平高度一致(R²=.88)。12色BCP-ALL MRD检测管兼容既有8色自动设门与识别(AGI)工具,且具有良好重复性。结果表明,该12色面板的检测表现与8色BCP-ALL MRD面板相当,适用于CD19阳性和阴性病例;同时它能更精确界定B细胞谱系,尤其有利于专家指导下的手工数据分析,并提供额外的可靶向标志物CD22表达信息。
Detection of minimal/measurable residual disease (MRD) is a critical prognostic marker in B-cell precursor acute lymphoblastic leukemia (BCP-ALL). The EuroFlow Consortium previously developed an 8-color flow cytometric MRD protocol, effective for >98% of BCP-ALL patients treated with chemotherapy. This study aimed to enhance MRD detection, particularly for patients treated with CD19-targeted therapies, by expanding the EuroFlow protocol to a 12-color panel. This new panel incorporates additional B-cell markers and exclusion T/NK-cell markers (CD3 and CD7). Through an evaluation of 237 diagnostic BCP-ALL samples, CD22, CD24, and HLA-DR were selected as additional B-cell gating markers. Two 12-color tubes were technically optimized and clinically validated across 101 patient follow-up samples, demonstrating excellent concordance with molecular MRD levels ( R 2 = 0.88). The 12-color BCP-ALL MRD tubes were compatible with the previously developed 8-color automated gating and identification (AGI) tool and demonstrated good reproducibility. Our findings indicate that the 12-color panel performs comparably to the 8-color BCP-ALL MRD panel, including both CD19-positive and CD19-negative cases. However, it offers an improved definition of the B-cell lineage, particularly for expert-guided manual data analysis, and provides additional information on the expression of the targetable marker CD22.
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