| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Yang, Tingting Dong, Yetian Zhang, Mingming Feng, Jingjing Fu, Shan Xiao, Pingnan Hong, Ruimin Xu, Huijun Cui, Jiazhen Huang, Simao Wei, Guoqing Kong, Delin Geng, Jia Chang, Alex H. Huang, He Hu, Yongxian |
| Abstract | Background Sequential CD19 and CD22 chimeric antigen receptor (CAR)-T cell therapy offers a promising approach to antigen-loss relapse in relapsed/refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL); however, research in adults remains limited. Methods This study aimed to evaluate the efficacy and safety of sequential CD19 and CD22 CAR-T cell therapy in adult patients with R/R B-ALL between November 2020 and November 2023 (ChiCTR2100053871). Key endpoints included the adverse event incidence, overall survival (OS), and leukemia-free survival (LFS). Results Twenty-three patients with a median age of 58.1 years (range 25.9–75.0) were enrolled. High-risk cytogenetic and genomic aberrations were identified in 43.5% of patients, and five patients had baseline extramedullary disease (EMD). The median interval between the two infusions was 3.8 months. Grade ≥ 3 hematological adverse events occurred at comparable rates after both infusions. Cytokine release syndrome was observed in 78.3% and 39.1% of patients after CD19 and CD22 CAR-T therapy, respectively. Two patients experienced grade 2 immune effector cell-associated neurotoxicity syndrome (ICANS) during CD19 CAR-T, and no ICANS was reported during CD22 CAR-T. The median OS was not reached with a median follow-up of 19.4 months (range 8.7–45.6), while the median LFS was 20.8 months. OS and LFS rates were 91.3% and 67.1% at 1 year and 58.6% and 47.0% at 2 years, respectively. Eight patients experienced relapse, with the cumulative incidence of relapse being 28.6% at 1 year and 42.5% at 2 years. Higher baseline leukemia burden (≥ 64% bone marrow blasts) and the presence of EMD were significant risk factors for inferior OS and LFS, respectively. Conclusions Sequential CAR-T cell therapy demonstrated durable efficacy and a manageable safety profile in R/R B-ALL, providing a viable option to address antigen-loss relapse and improve long-term outcomes in high-risk adult patients. |
| Related Links | https://ehoonline.biomedcentral.com/counter/pdf/10.1186/s40164-024-00593-5.pdf |
| Ending Page | 11 |
| Page Count | 11 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 21623619 |
| DOI | 10.1186/s40164-024-00593-5 |
| Journal | Experimental Hematology & Oncology |
| Issue Number | 1 |
| Volume Number | 14 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2025-01-03 |
| Access Restriction | Open |
| Subject Keyword | Hematology Oncology Cancer Research Relapsed/refractory B-cell acute lymphoblastic leukemia Chimeric antigen receptor Sequential therapy |
| Content Type | Text |
| Resource Type | Article |
| Subject | Hematology Oncology Cancer Research |
| Journal Impact Factor | 9.4/2023 |
| 5-Year Journal Impact Factor | 8.3/2023 |
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