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:Long-term outcomes of co-administration of CD19 and CD22 CAR-T cell therapy in pediatric patients with relapsed/refractory Philadelphia chromosome-positive acute lymphoblastic leukemia.
这些初步发现提示,CD19和CD22 CAR-T细胞疗法可能为R/R Ph+ ALL儿科患者提供长期生存获益,且毒性可控。然而,这些结果应被视为产生假设,需要在更大规模的对照研究中验证。
尽管初始治疗有反应,但酪氨酸激酶抑制剂(TKIs)耐药和疾病复发仍是费城染色体阳性急性淋巴细胞白血病(Ph + ALL)患者面临的主要挑战。鉴于CAR-T(CAR-T)细胞疗法在复发/难治性(R/R)ALL中的疗效,我们旨在评估CD19和CD22 CAR-T细胞疗法联合用于儿童R/R Ph + ALL患者的长期结局。
我们进行了一项针对R/R Ph + ALL患者的回顾性亚分析,以评估CD19和CD22 CAR-T细胞疗法联合给药的长期结局。完全血液学缓解(CHR)、可测量残留病阴性完全缓解(MRD - CR)、完全分子学缓解(CMR)、无复发生存期(RFS)和总生存期(OS)是截至2025年10月1日数据截止时评估的重要结局。
CAR-T细胞输注后1个月内,所有患者均达到CHR,MRD-CR和CMR分别为100%和77.8%。2例患者接受了巩固性异基因干细胞移植(allo-HSCT)。值得注意的是,6例患者在没有接受allo-HSCT的情况下实现了持续CHR。中位随访时间为54.93个月(范围,16.83-71.6个月),4年OS和RFS分别为91.7%和66.7%。未发生因CAR-T毒性导致的治疗相关死亡。
BACKGROUND: Despite initial responses, resistance to tyrosine kinase inhibitors (TKIs) and disease relapse remain major challenges in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL). Given the efficacy of chimeric antigen receptor T (CAR-T) cell therapy in Relapsed/Refractory (R/R) ALL, we aimed to evaluate the long-term outcomes of co-administration of CD19 and CD22 CAR-T cell therapy for pediatric patients with R/R Ph + ALL. METHODS: We conducted a retrospective subanalysis of patients with R/R Ph + ALL to assess the long-term outcomes of co-administration of CD19 and CD22 CAR-T cell therapy. Complete hematologic remission (CHR), measurable residual disease-negative complete remission (MRD - CR), complete molecular remission (CMR), relapse-free survival (RFS), and overall survival (OS) were among the important outcomes that were evaluated with a data cutoff of October 1, 2025. RESULTS: Within 1 month after CAR-T cell infusion, all patients achieved CHR, with MRD - CR and CMR of 100 and 77.8%, respectively. Two patients underwent consolidative allogeneic stem cell transplant (allo-HSCT). Notably, six patients achieved sustained CHR without allo-HSCT. At a median follow-up of 54.93 months (range, 16.83-71.6 months), the 4-year OS and RFS were 91.7 and 66.7%. No treatment-related deaths occurred from CAR-T toxicity. CONCLUSION: These preliminary findings suggest that CD19 and CD22 CAR-T cell therapy may provide long-term survival benefits in pediatric patients with R/R Ph + ALL, with manageable toxicity. However, these results should be considered hypothesis-generating and require validation in larger, controlled studies. CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/showproj.html?proj=52403, ChiCTR2000032211.
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