Abstract
BackgroundChimeric antigen receptor T (CAR-T) cell therapy simultaneously against CD19 and CD22 is an attractive strategy to address the antigen escape relapse after CD19-directed CAR-T cell therapies. However, the potential of optimizing the durability of remission by this approach in patients with B cell acute lymphoblastic leukemia (B-ALL) remains a critical unanswered question so far.Case presentationWe treated an adult patient with relapsed and refractory B-ALL after haploidentical hematopoietic stem cell transplantation (HSCT) by administering haploidentical CAR-T cells targeting both CD19 and CD22 following preparative lymphodepleting chemotherapy. This patient has remained in minimal residual disease-negative remission for more than 14 months and has been tapered off graft versus host disease prophylaxis.ConclusionsCAR simultaneously targeting CD19 and CD22 has the potential of inducing long-term remission in patients with B-ALL.
Highlights
Chimeric antigen receptor T (CAR-T) cell therapy simultaneously against CD19 and CD22 is an attractive strategy to address the antigen escape relapse after CD19-directed CAR-T cell therapies
Cumulative data from the clinical trials of donor-derived CAR-T cells have shown that donor-derived CAR-T cells targeting CD19 could effectively salvage relapsed B cell acute lymphoblastic leukemia (B-ALL) after allogeneic hematopoietic stem cell transplantation (HSCT) with a lesser risk of graft versus host disease (GVHD) flare [11,12,13]
Haplo-TanCAR-T 19/22 cells were still measurable with a low level of 2.29% of circulating T cells and the circulating B cells still had not recovered as the time of this report (Fig. 3c and Additional file 1: Figure S2)
Summary
We report on the immunologic and long-term clinical effects of this haploidentical (haplo) TanCAR-T 19/ 22 cells used in a compassionate use setting in a patient with relapsed and refractory adult B-ALL after haploHSCT. Haplo-TanCAR-T 19/22 cells were still measurable with a low level of 2.29% of circulating T cells and the circulating B cells still had not recovered as the time of this report (Fig. 3c and Additional file 1: Figure S2).
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