酪氨酸激酶抑制剂对CD19  CAR-T细胞在难治/复发Ph阳性急性淋巴细胞白血病中扩增的影响

doi:10.3969/j.issn.1004-583X.2020.10.009

临床荟萃

酪氨酸激酶抑制剂对CD19 CAR-T细胞在难治/复发Ph阳性急性淋巴细胞白血病中扩增的影响

天津市第一中心医院血液科，天津 300192

出版日期:2020-10-20 发布日期:2020-09-04
通讯作者: 邓琦，Email: kachydeng@hotmail.com
基金资助:
国家自然科学基金资助项目----GATA4在人iPSCs定向肝窦内皮细胞分化中的功能及机制研究（81900186）

Influence of TKIs on proliferation of CD19 CAR-T cells in refractory/relapsed Ph+ acute lymphoblastic leukemia

Department of Hematology, Tianjin First Central Hospital, Tianjin 300192, China

Online:2020-10-20 Published:2020-09-04
Contact: Corresponding author：Deng Qi, Email: kachydeng@hotmail.com

摘要/Abstract

摘要： 目的观察酪氨酸激酶抑制剂(tyrosine kinase inhibitors, TKIs)对CD19嵌合抗原受体修饰（CAR）T细胞在难治/复发Ph+急性淋巴细胞白血病（ALL）中的扩增、疗效及不良反应的影响。方法收集10例难治/复发Ph+ ALL患者（TKIs组）和16例难治/复发Ph阴性BALL患者（非TKIs组），TKIs组给予TKIs口服。在输注CD19 CART细胞后第0、4、7、14、21和28天分别检测外周血中CD19 CART细胞，分析两组输注后的疗效及不良反应。结果 TKIs组外周血中CD19 CART细胞的峰值高于非TKIs组，两组差异有统计学意义（P=0.0037）；两组细胞因子峰值、细胞因子释放综合征（CRS）分级、第14天完全缓解（CR）率、总生存率（OS）和无病生存率（DFS）差异均无统计学意义（P>0.05）。结论 TKIs促进CD19 CART细胞在难治/复发Ph+ ALL中的扩增，不抑制CD19 CART细胞的疗效，不加重其不良反应，近期及远期疗效肯定。

关键词: 白血病, 淋巴样, 嵌合抗原受体, 酪氨酸激酶抑制剂, 费城染色体阳性

Abstract: Objective To observe the influence of tyrosine kinase inhibitors (TKIs) on the proliferation, efficacy and adverse reactions (AEs) of CD19 CART cells in refractory/relapsed Ph+ acute lymphoblastic leukemia (Ph+ ALL).Methods Ten patients with refractory/relapsed Ph+ ALL (TKIs group) and 16 patients with refractory/relapsed Phnegative BALL (nonTKIs group) were collected, and TKIs group was given TKIs orally. CD19 CART cells were detected in peripheral blood at 0, 4, 7, 14, 21 and 28 days after infusion, and the clinical efficacy and AEs of two groups were analyzed. Results The peak value of CD19 CART cells in peripheral blood in TKIs group was higher than that in nonTKIs group, with statistically significant differences between the two groups (P=0.0037). There were no statistically significant differences in cytokine peak, cytokine release syndrome (CRS) grading, the complete response (CR) rate at day 14, overall survival (OS) rate and diseasefree survival (DFS) rate between the two groups (P>0.05). Conclusion TKIs promoted the proliferation of CD19 CART cells in refractory/relapsed Ph+ ALL, without inhibiting the clinical efficacy of CD19 CART cells and aggravating AEs, which showed positively shortterm and longterm effects.

Key words: leukemia, , lymphoblastic; , chimeric antigen receptor, tyrosine kinase inhibitors; , philadelphia chromosome positive

吕翠翠，李新，李青，穆娟，王嘉，袁婷，江嫣雨，邓琦. 酪氨酸激酶抑制剂对CD19 CAR-T细胞在难治/复发Ph阳性急性淋巴细胞白血病中扩增的影响[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2020.10.009.

Lyu Cuicui, Li Xin, Li Qing, Mu Juan, Wang Jia, Yuan Ting, Jiang Yanyu, Deng Qi. Influence of TKIs on proliferation of CD19 CAR-T cells in refractory/relapsed Ph+ acute lymphoblastic leukemia[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2020.10.009.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2020.10.009

https://huicui.hebmu.edu.cn/CN/Y2020/V35/I10/909

[1]	刘丽丽, 袁宇婷, 赖耿良, 田川, 蓝翔, 叶中绿. 儿童急性淋巴细胞白血病第15天微小残留与预后的关系[J]. 临床荟萃, 2024, 39(1): 47-52.
[2]	董整荣, 陶千山, 沈元元, 董毅. 163例急性早幼粒细胞白血病患者随访结果分析[J]. 临床荟萃, 2023, 38(9): 813-818.
[3]	陈瑾, 吕鸿雁, 刘晗, 刘建宁, 卢佳配, 张金巧. 靶向BCMA的嵌合抗原受体T细胞治疗三重难治性多发性骨髓瘤的研究进展[J]. 临床荟萃, 2023, 38(7): 654-658.
[4]	杜佳宜, 刘丽丽, 何永忠, 田川, 蓝翔, 叶中绿. 儿童急性淋巴细胞白血病化疗期间严重不良事件临床观察[J]. 临床荟萃, 2023, 38(2): 149-154.
[5]	陈璨, 黄永芬, 苗雨青. 老年急性髓样白血病的治疗进展[J]. 临床荟萃, 2023, 38(10): 954-960.
[6]	张月月, 谢美芳, 孙艮. 类风湿关节炎合并T-细胞大颗粒淋巴细胞白血病1例及文献复习[J]. 临床荟萃, 2022, 37(8): 728-732.
[7]	李青, 邓琦. 嵌合抗原受体T细胞治疗复发难治弥漫大B细胞淋巴瘤进展[J]. 临床荟萃, 2022, 37(2): 182-187.
[8]	吕翠翠, 沈俊, 邓琦. 嵌合抗原受体巨噬细胞的研究进展[J]. 临床荟萃, 2022, 37(12): 1132-1136.
[9]	李书凡, 王玉秀, 姜正华. T790M突变与TKI获得性耐药的晚期肺腺癌患者预后的相关性[J]. 临床荟萃, 2022, 37(11): 985-991.
[10]	尹玲玲, 吴文健, 朱锋. 急性髓系白血病转换为急性淋巴细胞白血病1例并文献复习[J]. 临床荟萃, 2022, 37(11): 1025-1030.
[11]	何一文, 乔田奎. CEA、CA125、CYFRA21-1水平在EGFR-TKIs治疗EGFR突变阳性的非小细胞肺腺癌疗效评估中的临床价值[J]. 临床荟萃, 2021, 36(3): 220-224.
[12]	刘建宁, 孙立, 牛志云, 温树鹏, 王颖, 张学军, 王福旭. PD-1在急性白血病异基因造血干细胞移植后T淋巴细胞的表达[J]. 临床荟萃, 2021, 36(3): 251-255.
[13]	黄嘉惠, 叶中绿. 儿童白血病合并多重耐药菌感染的研究进展[J]. 临床荟萃, 2021, 36(2): 188-192.
[14]	沈子园, 康海全, 桑威, 闫冬梅. 白血病合并感染患者细菌分布、耐药情况及死亡危险因素分析[J]. 临床荟萃, 2021, 36(12): 1092-1096.
[15]	马瑞, 孙于谦. 单倍型相合移植规范化治疗急性白血病[J]. 临床荟萃, 2021, 36(10): 869-873.

酪氨酸激酶抑制剂对CD19 CAR-T细胞在难治/复发Ph阳性急性淋巴细胞白血病中扩增的影响

Influence of TKIs on proliferation of CD19 CAR-T cells in refractory/relapsed Ph+ acute lymphoblastic leukemia

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价