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Sequential Infusion of Anti-CD22 and Anti-CD19 Chimeric Antigen Receptor T Cells for a Pediatric Ph-Like B-ALL Patient That Relapsed After CART-Cell and Haplo-HSCT Therapy: A Case Report and Review of Literature

Authors Hua J, Qian W, Wu X, Zhou L, Yu L, Chen S, Zhang J, Qiu H

Received 24 October 2019

Accepted for publication 12 February 2020

Published 17 March 2020 Volume 2020:13 Pages 2311—2317


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Carlos E Vigil

Jingsheng Hua,1,2 Weiqing Qian,3 Xiaoxia Wu,1 Lili Zhou,1 Lei Yu,4 Suning Chen,1 Jian Zhang,1 Huiying Qiu1

1Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, People’s Republic of China; 2Department of Hematology, Taizhou Municipal Hospital, Taizhou 318000, Zhejiang, People’s Republic of China; 3Suzhou Vocational Health College, Suzhou, Jiangsu, People’s Republic of China; 4College of Chemistry and Molecular Engineering, East China Normal University, Shanghai, People’s Republic of China

Correspondence: Huiying Qiu Tel +8613912792913
Fax +8651267781850

Abstract: Pediatric Philadelphia chromosome-like (Ph-like) acute B-lymphoblastic leukemia (B-ALL), a high-risk subset of B-ALL characterized by a gene expression profile similar to that of Ph-positive ALL, has extremely poor outcome after a relapse following autologous chimeric antigen receptor (CAR)-T and haploidentical (haplo) hematopoietic stem cell transplantation(HSCT)therapy. with very limited treatment options. Donor-derived CAR T-cell therapy, the most vital advanced anticancer technology, may be a promising salvage strategy for patients with Ph-like B-ALL. Here, we presented a relapsed and refractory case of a child with Ph-like B-ALL after autologous anti-CD19 CAR T-cell therapy followed by haplo-HSCT. She successfully achieved the fourth complete remission (CR4) and maintained CR for five months after the sequential infusion of donor-derived anti-CD22 and anti-CD19 CAR T cells, with mild CRS side effects and no obvious graft-versus-host disease. A donor-derived anti-CD22 and -CD19 CAR T-cell therapy combined with a sequential infusion strategy may provide a promising alternative treatment strategy as effective and safe salvage therapy for children with recurrent and refractory Ph-like B-ALL after autologous CD19-directed CAR T-cell therapy followed by haplo-HSCT.

Keywords: Philadelphia-chromosome-like, acute lymphoblastic leukemia, chimeric antigen receptor, CD19, CD22

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