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Recently, Dr.
Pull out the pain points of the treatment "allogeneic hematopoietic stem cell transplantation recurrence T-ALL/LBL"
Professor Ke Xiaoyan said that T-ALL/LBL relapsed after allogeneic hematopoietic stem cell transplantation and required secondary allogeneic transplantation
In recent years, the team of Professors Ke Xiaoyan and Hu Kai have accumulated rich experience in the field of CAR-T treatment of B-cell lymphoma, and now use the donor-derived CD7 CAR-T cell therapy as a T-ALL/LBL bridging tumor reduction program after allogeneic hematopoietic stem cell transplantation, which has obtained good efficacy
Overcoming the difficulties of "CD7 CAR-T" treatment
CD7 CAR-T cell therapy has a difficult point, because the T lymphocytes themselves express CD7 antigens, CD7 CAR-T cells are prone to "suicide" when cultured in vitro, so that a sufficient number of CAR-T cells cannot be guaranteed for treatment, and CAR-T may not be able to expand, and the treatment fails
Dr.
Thoughts triggered by "CD7 CAR-T" cell therapy
Although we have observed good efficacy, there are still many problems that need to be solved
Dr.
Hui Shi said that after the patients infused with CD7 CAR-T cells, CD7+ cells were observed to disappear after two weeks, up to 1 year of follow-up, and no recovery of cd7+ T cell subsets was observed (see figure below
).
At the same time, T lymphocyte reconstitution of CD7- can be observed, is such immune reconstitution different from CD7+ T lymphocytes in terms of function? At present, there are very few such studies and it is unknown; In addition to immune reconstitution problems, we also observed that 6/7 patients had severe haematological toxicity of leukopenia, thrombocytopenia and neutropenia after CD7 CAR-T treatment, and bone marrow hematopoietic recovery was slow, and secondary infections were more common
.
Therefore, it is recommended that patients with conditions re-build blood and immune function
with bridging secondary transplantation after remission of CD7 CAR-T therapy.
In patients with unconditional secondary transplantation, the effect on hematopoietic and immune function needs to be observed
for a long time.
In summary, Professor Hu Kai said that the team's preliminary research shows that CD7 CAR-T cell therapy technology may be an effective treatment for bridging secondary transplantation of patients with recurrent T-ALL/LBL after allogeneic hematopoietic stem cell transplantation, and the safety of CAR-T is controllable
.
Is CD7 CAR-T cell therapy long-term effective in patients with unconditional secondary transplantation? Can you prolong the survival of this part of the patient? In order to answer this question, we have carried out further clinical observation and basic research, and look forward to finding more suitable and effective treatment methods in continuous exploration, saving more patients, and allowing everyone to restore their health and embrace a new life
.
Professor Ke Xiaoyan
Chief Physician, Doctor of Medicine, Doctoral Supervisor, Second-level Professor
Chief Physician of the Department of Hematology, Peking University Third Hospital
Leader of the Adult Lymphoma Discipline of Gaobo Medical (Blood Disease) Beijing Research Center
Chief Consultant of The Department of Adult Lymphoma, Beijing Gaobo Boren Hospital, Beijing Research Center of Gaobo Medical (Blood Disease).
Former Chairman of the Hematology Society of the Chinese Association of Women Physicians
Chairman of the Targeted Professional Committee of the Chinese Association of Women Physicians
Executive Vice Chairman of the Oncology Expert Committee of the Chinese Association of Women Physicians
Former Chairman of the Hematology Society of the Chinese Association of Women Physicians
Chairman of the Targeted Professional Committee of the Chinese Association of Women Physicians
Executive Vice Chairman of the Oncology Expert Committee of the Chinese Association of Women Physicians
Vice Chairman of the Hematology and Tumor Committee of the Chinese Geriatric Association
Vice Chairman of the Hematology Professional Committee of the China Medical Education Association
Member of the Standing Committee of the Lymphoma Committee of the Chinese Anti-Cancer Association
Associate Editor of journal leukemia lymphoma, editorial board member of several journals
Expert of medical technology appraisal and consulting expert of Ministry of Health and Beijing Municipality
Central Health Consultation Specialist
Professor Hu Kai
Chief Physician, M.
DDirector of the Department of Adult Lymphoma/Myeloma at Beijing Gaobo Boren Hospital
Member of the Geriatric Oncology Committee of the Chinese Gerontology Society
He is an expert member of the beijing medical association's municipal "hub-type" social organization
Member of the Blood Professional Committee of beijing perioperative medical research association
Member of the first China T-cell lymphoma working group of the Hematology and Tumor Professional Committee of the Chinese Anti-Cancer Association
Member of the Health Science Popularization Professional Committee of the Chinese Health Management Association
Member of the Hematopoietic Stem Cell Transplantation and Cell Therapy Professional Committee of the Chinese Medical Education Association
Member of the Clinical Research Committee of Beijing Oncology Association
He is a youth member of the Blood Committee of Beijing Medical Association
Participated in more than 20 international and domestic multi-center clinical studies; The first author and corresponding author published more than 30 papers in Chinese and English; Edited and translated 5 books; He has reported the team's research results at many academic conferences at home and abroad (American Hematology Annual Conference, European Hematology Annual Conference).
Research interests: integrated diagnosis of tumors in lymphohematopoietic system, standardized therapy, molecular targeted therapy and immunotherapy, hematopoietic stem cell transplantation
.
He has rich experience in the diagnosis and treatment of relapsed refractory lymphoma and myeloma, and has completed more than 500 cases of R/R lymphoma and MYEL CAR-T cell therapy
Dr.
Hui Shi
Doctor of Medicine
Attending physician of the Department of Adult Lymphoma/Myeloma of Beijing Gaobo Boren Hospital
Doctoral candidate in internal medicine from the Institute of Hematology, Chinese Academy of Medical Sciences-Peking Union Medical College
Visiting Scholar in Biochemistry and Molecular Biology, University of Miami, USA
He is engaged in targeted therapy for lymphoma, immunotherapy including CART cell therapy, and hematopoietic stem cell transplantation for blood diseases
.
Participated in more than 20 international and domestic multi-center clinical studies; The first author and corresponding author published more than 10 papers in Chinese and English; He has spoken at many academic conferences at home and abroad (American Hematology Annual Conference, European Hematology Annual Conference).
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