CD22 CAR T-cell therapy in refractory or relapsed B acute lymphoblastic leukemia

Leukemia. 2019 Dec;33(12):2854-2866. doi: 10.1038/s41375-019-0488-7. Epub 2019 May 20.

Abstract

Despite worldwide promising clinical outcome of CD19 CAR-T therapy, relapse after this therapy is associated with poor prognosis and has become an urgent problem to be solved. We conducted a CD22 CAR T-cell therapy in 34 relapsed or refractory (r/r) B-ALL pediatric and adult patients who failed from previous CD19 CAR T-cell therapy. Complete remission (CR) or CR with incomplete count recovery (CRi) was achieved in 24 of 30 patients (80%) that could be evaluated on day 30 after infusion, which accounted for 70.5% of all 34 enrolled patients. Most patients only experienced mild cytokine-release syndrome and neurotoxicity. Seven CR patients received no further treatment, and 3 of them remained in remission at 6, 6.6, and 14 months after infusion. Eleven CR patients were promptly bridged to transplantation, and 8 of them remained in remission at 4.6 to 13.3 months after transplantation, resulted in 1-year leukemia-free survival rate of 71.6% (95% CI, 44.2-99.0). CD22 antigen loss or mutation was not observed to be associated with relapsed patients. Our study demonstrated that our CD22 CAR T-cells was highly effective in inducing remission in r/r B-ALL patients, and also provided a precious window for subsequent transplantation to achieve durable remission.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antigens, Neoplasm / immunology
  • Antigens, Neoplasm / metabolism
  • Biopsy
  • Child
  • Child, Preschool
  • Combined Modality Therapy / adverse effects
  • Combined Modality Therapy / methods
  • Cytokines / metabolism
  • Cytotoxicity, Immunologic
  • Disease Management
  • Female
  • Follow-Up Studies
  • Humans
  • Immunotherapy, Adoptive* / adverse effects
  • Immunotherapy, Adoptive* / methods
  • Infant
  • Male
  • Middle Aged
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / diagnosis
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / etiology
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / immunology*
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Receptors, Antigen, T-Cell / genetics
  • Receptors, Antigen, T-Cell / metabolism*
  • Receptors, Chimeric Antigen / genetics
  • Receptors, Chimeric Antigen / metabolism*
  • Sialic Acid Binding Ig-like Lectin 2 / antagonists & inhibitors*
  • Sialic Acid Binding Ig-like Lectin 2 / metabolism
  • T-Lymphocytes / immunology*
  • T-Lymphocytes / metabolism*
  • Young Adult

Substances

  • Antigens, Neoplasm
  • CD22 protein, human
  • Cytokines
  • Receptors, Antigen, T-Cell
  • Receptors, Chimeric Antigen
  • Sialic Acid Binding Ig-like Lectin 2