Frontiers in Oncology (Nov 2021)
Efficacy and Safety of Chimeric Antigen Receptor T Cells in Acute Lymphoblastic Leukemia With Post-Transplant Relapse
- Lijuan Ding,
- Lijuan Ding,
- Lijuan Ding,
- Lijuan Ding,
- Yiyun Wang,
- Yiyun Wang,
- Yiyun Wang,
- Yiyun Wang,
- Ruimin Hong,
- Ruimin Hong,
- Ruimin Hong,
- Ruimin Hong,
- Houli Zhao,
- Houli Zhao,
- Houli Zhao,
- Houli Zhao,
- Linghui Zhou,
- Linghui Zhou,
- Linghui Zhou,
- Linghui Zhou,
- Guoqing Wei,
- Guoqing Wei,
- Guoqing Wei,
- Guoqing Wei,
- Wenjun Wu,
- Wenjun Wu,
- Wenjun Wu,
- Wenjun Wu,
- Huijun Xu,
- Huijun Xu,
- Huijun Xu,
- Huijun Xu,
- Yanlei Zhang,
- Yi Luo,
- Yi Luo,
- Yi Luo,
- Yi Luo,
- Jimin Shi,
- Jimin Shi,
- Jimin Shi,
- Jimin Shi,
- Alex H. Chang,
- Yongxian Hu,
- Yongxian Hu,
- Yongxian Hu,
- Yongxian Hu,
- He Huang,
- He Huang,
- He Huang,
- He Huang
Affiliations
- Lijuan Ding
- Bone Marrow Transplantation Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Lijuan Ding
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Lijuan Ding
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Lijuan Ding
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Yiyun Wang
- Bone Marrow Transplantation Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Yiyun Wang
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Yiyun Wang
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Yiyun Wang
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Ruimin Hong
- Bone Marrow Transplantation Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Ruimin Hong
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Ruimin Hong
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Ruimin Hong
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Houli Zhao
- Bone Marrow Transplantation Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Houli Zhao
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Houli Zhao
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Houli Zhao
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Linghui Zhou
- Bone Marrow Transplantation Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Linghui Zhou
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Linghui Zhou
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Linghui Zhou
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Guoqing Wei
- Bone Marrow Transplantation Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Guoqing Wei
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Guoqing Wei
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Guoqing Wei
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Wenjun Wu
- Bone Marrow Transplantation Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Wenjun Wu
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Wenjun Wu
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Wenjun Wu
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Huijun Xu
- Bone Marrow Transplantation Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Huijun Xu
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Huijun Xu
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Huijun Xu
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Yanlei Zhang
- Shanghai YaKe Biotechnology Ltd, Shanghai, China
- Yi Luo
- Bone Marrow Transplantation Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Yi Luo
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Yi Luo
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Yi Luo
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Jimin Shi
- Bone Marrow Transplantation Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Jimin Shi
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Jimin Shi
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Jimin Shi
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Alex H. Chang
- Shanghai YaKe Biotechnology Ltd, Shanghai, China
- Yongxian Hu
- Bone Marrow Transplantation Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Yongxian Hu
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Yongxian Hu
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Yongxian Hu
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- He Huang
- Bone Marrow Transplantation Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- He Huang
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- He Huang
- Institute of Hematology, Zhejiang University, Hangzhou, China
- He Huang
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- DOI
- https://doi.org/10.3389/fonc.2021.750218
- Journal volume & issue
-
Vol. 11
Abstract
Twenty patients with relapsed B-ALL after HSCT were treated with CAR T cell therapy and were evaluated for efficacy and safety. Twelve patients previously received haploidentical transplantation, while 8 patients received HLA-matched transplantation. The median relapse time was 12 months (range, 4 to 72). Thirteen patients received autologous CAR T cells, and 7 patients received allogeneic CAR T cells, which were derived from transplant donors. The median infusion dose was 2.9×106/kg (range, 0.33 to 12×106/kg). Nineteen patients were evaluated for efficacy, among which 17 patients (89.5%) achieved MRD negative. The CR rates in the HLA-matched transplantation group and haploidentical transplantation group were 100% (7/7) and 83.3% (10/12), respectively. The median follow-up time was 9.80 months (range, 2.40 to 64.97). Ten patients (50%) died of relapse, 3 patients (15%) died of infection, and 1 patient (5%) died of aGVHD. Fifteen patients (75%) developed CRS, including 3 (20%) grade 1 CRS, 6 (40%) grade 2 CRS, and 6 (40%) grade 3 CRS. Ten patients (50%) developed aGVHD, including 1 (10%) grade I aGVHD, 6 (60%) grade II aGVHD, and 3 (30%) grade III aGVHD. The log rank test showed that CAR T cell origin was correlated with aGVHD occurrence in the haploidentical transplantation group (P = 0.005). The authors’ study indicated that the initial efficacy and safety of CAR T cell therapy for patients with post-transplant relapse were satisfactory. However, aGVHD was a concern in patients with a history of haploidentical transplantation occupied with allogeneic CAR T cells, which warrants clinical attention.
Keywords
- chimeric antigen receptor T cells
- post-transplant relapse
- acute graft versus host disease
- cytokine release syndrome
- acute lymphoblastic leukemia
