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:Outcomes of locally produced donor-derived anti-CD19 chimeric antigen receptor T-cells in relapsed or refractory B-cell acute lymphoblastic leukemia patients.
在中位随访时间47个月(范围,6-104个月)时,有8例患者仍然存活且MRD阴性。
供者来源的抗CD19CAR-T 细胞(CAR T细胞)疗法已成为治疗复发/难治性(R/R)B细胞急性淋巴细胞白血病(B-ALL)最有前景的治疗方法之一。在这项回顾性研究中,我们评估了在我们本地符合GMP标准的生产设施中制备的供者来源抗CD19 CAR T细胞的安全性和有效性。11例R/R B-ALL患者接受了供者来源抗CD19 CAR T细胞治疗。11例患者中有7例既往接受过异基因造血干细胞移植(allo-HSCT)。所有11例患者在输注后第28天均达到微小残留病(MRD)阴性。3例患者发生1级细胞因子释放综合征(CRS),1例患者发生2级CRS。未观察到免疫效应细胞相关神经毒性综合征(ICANS)病例。发生2级CRS的患者还发生了2级移植物抗宿主病(GVHD)。在中位随访时间47个月(范围,6-104个月)时,8例患者仍存活且MRD阴性。3例患者死亡:1例死于骨髓(BM)复发,1例死于骨髓和中枢神经系统(CNS)同时复发,1例死于念珠菌血症。5年总生存率和无事件生存率均为70%。在这项回顾性研究中,在符合GMP标准的环境中制备的供者来源抗CD19 CAR T细胞在治疗R/R B-ALL患者中表现出良好的安全性特征和高疗效。需要更大规模的研究来证实这些发现。
Donor-derived anti-CD19 chimeric antigen receptor T-cell (CAR T-cell) therapy has emerged as one of the most promising treatments for relapsed/refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL). In this retrospective study, we evaluated the safety and efficacy of donor-derived anti-CD19 CAR T cells manufactured at our local GMP-compliant production facility. Eleven patients with R/R B-ALL received donor-derived anti-CD19 CAR T-cell therapy. Seven of the eleven patients had previously undergone allogeneic hematopoietic stem cell transplantation (allo-HSCT). All eleven patients achieved minimal residual disease (MRD) negativity by day 28 post-infusion. Three patients developed grade 1 cytokine release syndrome (CRS), and one patient developed grade 2 CRS. No case of immune effector cell-associated neurotoxicity syndrome (ICANS) was observed. The patient who experienced grade 2 CRS also developed grade 2 graft-versus-host disease (GVHD. At the median follow-up time of 47 months (range, 6-104 months), eight patients remained alive and MRD-negative. Three patients died: one from bone marrow (BM) relapse, one from concurrent BM and central nervous system (CNS) relapses, and one from candidemia. The 5-year overall survival and event-free survival rates were both 70%. In this retrospective study, donor-derived anti-CD19 CAR T-cells produced in a GMP-compliant environment demonstrated a favorable safety profile and high efficacy in treating patients with R/R B-ALL. Larger studies are warranted to confirm these findings.
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