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
英文原题:Case Report: Combined umbilical cord blood and peripheral blood stem cell transplantation with donor lymphocyte infusion for R/R AML post CAR-CLL1 failure.
Case Report: Combined umbilical cord blood and peripheral blood stem cell transplantation with donor lymphocyte infusion for R/R AML post CAR-CLL1 failure.
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复发/难治性急性髓系白血病(R/R AML)预后极差,尤其是对CAR-T 细胞治疗失败的患者,目前尚无有效治疗选择。我们报告一例35岁男性AML患者,在接受多线高强度化疗后复发。给予挽救性CAR-CLL1治疗后,患者未能实现造血恢复或免疫重建,随后在一个月内疾病快速复发并进展为感染性休克。在此关键时刻,常规治疗被证明不足以应对。异基因造血干细胞移植(allo-HSCT)包括外周血干细胞移植(PBSCT)和脐带血(UCB)。该患者接受了UCB联合PBSCT并辅以供者淋巴细胞输注(DLI)。此后患者获得持续缓解,但出现了皮肤和肠道移植物抗宿主病(GVHD),目前病情已得到控制。本病例提示,UCB联合PBSCT并辅以DLI可能代表CAR-T 治疗失败后R/R AML的一种潜在治疗选择,值得在类似高危情境中进一步研究。
Relapsed/refractory acute myeloid leukemia (R/R AML) carries an extremely poor prognosis, particularly in patients who fail chimeric antigen receptor T-cell (CAR-T) therapy, with no effective treatment options currently available.
We report a 35-year-old male with AML who experienced relapse after multiple lines of high-intensity chemotherapy. Salvage CAR-CLL1 therapy was administered, but the patient failed to achieve hematopoietic recovery or immune reconstitution, followed by rapid disease relapse within one month and progression to septic shock. At this critical juncture, conventional therapies proved insufficient. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) includes peripheral blood stem cell transplantation (PBSCT) and umbilical cord blood (UCB).
The patient underwent combined UCB and PBSCT with donor lymphocyte infusion (DLI). He has since achieved sustained remission, though developed cutaneous and intestinal graft-versus-host disease (GVHD), which is currently under control. This case highlights that combined UCB and PBSCT with DLI may represent a potential therapeutic option for R/R AML following CAR-T therapy failure, warranting further investigation in similar high-risk scenarios.
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