Donor-derived anti-CD19 CAR T cells compared with donor lymphocyte infusion for recurrent B-ALL after allogeneic hematopoietic stem cell transplantation

• DOI: 10.1038/s41409-020-01140-6
• Publication Date: 2020-11-24T14:26:47Z
• Authors: Jingsheng Hua; Jian Zhang; Xinyou zhang; Xiaoxia Wu; Lili Zhou; Xiebing Bao; Yue Han; Miao Miao; Caixia Li; Chengcheng Fu; Suning Chen; Xiaowen Tang; Depei Wu; Huiying Qiu
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Lymphocyte Transfusion; T-Lymphocytes; Hematopoietic Stem Cell Transplantation; Graft vs Host Disease; Humans; Lymphocytes; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Immunotherapy, Adoptive; 3. Good health

The efficacy and safety of donor-derived anti-CD19 CAR T cells vs DLI for the management of relapsed B-cell acute lymphoblastic leukemia (B-ALL) after allo-hematopoietic stem cell transplantation (HSCT) remain unclear. Thirteen B-ALL patients with relapsed after allo-HSCT and thus were treated with donor-derived anti-CD19 CAR T-cell (study group). Fifteen B-ALL patients relapsed after allo-HSCT and thus were treated with DLI (DLI group). The rates of MRD-negative complete remission (61.5%) in the study group were significantly higher than those in the DLI group (13.3%) (p = 0.02). The complete remission duration in study group and DLI group were median 8.0 months (range, 3-25 months) and 4.4 months (range, 1-25 months; p = 0.026), respectively. The overall survival of patients in the study group was superior to that of the DLI group: 9.5 months (range,3-25 months) versus 5.5 months (range, 1-25 months; p = 0.030). One patient with grade 1 acute graft-versus-host disease (aGVHD) was identified in the study group. While five (33.3%) patients in the DLI group developed grades III-IV aGVHD. Three patients (23.07%) developed grade 3 or 4 cytokine release syndrome in the study group. This study suggested that donor-derived anti-CD19 CAR T-cell therapy is promising, safe, and potentially effective for relapsed B-ALL after allo-HSCT and may be superior to DLI.