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- Title
CD19 CAR-T cell treatment conferred sustained remission in B-ALL patients with minimal residual disease.
- Authors
Lu, Wenyi; Wei, Yunxiong; Cao, Yaqing; Xiao, Xia; Li, Qing; Lyu, Hairong; Jiang, Yili; Zhang, Huan; Li, Xin; Jiang, Yanyu; Meng, Juanxia; Yuan, Ting; Zhu, Haibo; He, Xiaoyuan; Jin, Xin; Sun, Rui; Sui, Tao; Liu, Kaiqi; Zhao, Mingfeng
- Abstract
The persistence or recurrence of minimal residual disease (MRD) after chemotherapy predicts relapse of B-cell acute lymphoblastic leukemia (B-ALL). CD19-directed chimeric antigen receptor T (CD19 CAR-T) cells have shown promising responses in B-ALL. However, their role in chemotherapy-refractory MRD-positive B-ALL remains unclear. Here we aimed to assess the effectiveness and safety of CD19 CAR-T cells in MRD-positive B-ALL patients. From January 2018, a total of 14 MRD-positive B-ALL patients received one or more infusions of autogenous CD19 CAR-T cells. Among them, 12 patients achieved MRD-negative remission after one cycle of CAR-T infusion. At a median follow-up time of 647 days (range 172–945 days), the 2-year event-free survival rate in MRD-positive patients was 61.2% ± 14.0% and the 2-year overall survival was 78.6 ± 11.0%, which were significantly higher than patients with active disease (blasts ≥ 5% or with extramedullary disease). Moreover, patients with MRD had a lower grade of cytokine release syndrome (CRS) than patients with active disease. However, the peak expansion of CAR-T cells in MRD positive patients showed no statistical difference compared to patients with active disease. Five patients received two or more CAR-T cell infusions and these patients showed a decreased peak expansion of CAR-T cell in subsequent infusions. In conclusion, pre-emptive CD19 CAR-T cell treatment is an effective and safe approach and may confer sustained remission in B-ALL patients with chemotherapy-refractory MRD. The trials were registered at www.chictr.org.cn as ChiCTR-ONN-16009862 (November 14, 2016) and ChiCTR1800015164 (March 11, 2018).
- Subjects
CYTOKINE release syndrome; SURVIVAL rate; OVERALL survival; CHIMERIC antigen receptors; EXTRAMEDULLARY diseases; DISEASE remission
- Publication
Cancer Immunology, Immunotherapy, 2021, Vol 70, Issue 12, p3501
- ISSN
0340-7004
- Publication type
Article
- DOI
10.1007/s00262-021-02941-4