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Delayed remission following sequential infusion of humanized CD19- and CD22-modified CAR-T cells in a patient with relapsed/refractory acute lymphoblastic leukemia and prior exposure to murine-derived CD19-directed CAR-T cells

Authors Yang F, Zhang J, Zhang X, Tian M, Wang J, Kang L, Qiu H, Wu D

Received 28 September 2018

Accepted for publication 14 February 2019

Published 25 March 2019 Volume 2019:12 Pages 2187—2191


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 2

Editor who approved publication: Dr Sanjay Singh

Fei Yang,1,* Jian Zhang,1,* Xinyou Zhang,2,* Mengli Tian,1 Jingjing Wang,1 Liqing Kang,3 Huiying Qiu,1 Depei Wu1

1Department of Hematology, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China; 2Department of Hematology, The Second Clinical Medical College of Jinan University (Shenzhen People’s Hospital), Jinan University, Shenzhen, Guangdong Province, People’s Republic of China; 3Institute of Biomedical Engineering and Technology, Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, School of Chemistry and Molecular Engineering, East China Normal University, Shanghai, People’s Republic of China

*These authors contributed equally to this work

Background: CD19-modified CAR-T cells greatly influence responses in patients with relapsed/refractory acute lymphoblastic leukemia (ALL). However, recurrence remains a challenge, and reinfusion of CAR-T cells is not always effective. Sequential infusion of humanized CD19-modified and CD22-modified CAR-T cells may overcome this issue and induce remission.
Methods: We examined treatment with sequential infusion of humanized CD19-modified and CD22-modified CAR-T cells in a patient with relapsed ALL previously exposed to murine-derived anti-CD19 CAR-T cells.
Results: At ~6 weeks after treatment, repeated bone marrow smear and flow cytometry analysis revealed no lymphoblasts.
Conclusion: Our results suggest that sequential infusion of humanized CD19-modified and CD22-modified CAR-T cells is a valuable option for relapsed patients with prior infusion of murine-derived, CD19-directed CAR-T cells.

Keywords: chimeric antigen receptor, anti-CD19, anti-CD22, humanized, acute lymphoblastic leukemia, relapsed

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