DNT cells mediate resistance to CAR-T cells therapy in a pediatric patient with relapsed and refractory B-ALL

• DOI: 10.1007/s00277-024-05790-0
• Publication Date: 2024-05-10T02:01:36Z
• Authors: Ruotong Chen; Qianshan Tao; Fan Wu; Zhimin Zhai; Yuchen Jiang; Caixian Xu; Huiping Wang
• Keywords: Refractory (planetary science); Hematology

Chimeric antigen receptor T (CAR-T) cells therapy is a milestone achievement in the immunotherapy of relapsed and refractory (R/R) B cell acute lymphoblastic leukemia (B-ALL). However, some patients treated with CAR-T cells do not achieve complete remission, the mechanisms of which have not been elucidated. In the present study, we report a 9-year-old pediatric patient with refractory B-ALL received a triple infusion of autologous CD19 CAR-T cells therapy after the second relapse. CAR-T cells expanded in the peripheral blood and bone marrow. However, the patient did not achieve complete remission, indicating a lack of response to CAR-T cells therapy. Analysis of etiological factors revealed that the number of CD4 and CD8 double-negative T (DNT) cells was significantly upregulated in the peripheral blood, bone marrow, and autologous CAR-T cells products. In conclusiont, these findings indicate that DNT cells mediated resistance to CAR-T cells therapy in this pediatric patient with R/R B-ALL.