Control effect of Dasatinib on the treatment of acute myeloid leukemia and adverse events of CD123 targeting CAR-T: a case report and literature review

Chunmin LI; Yu LI; Zhongtao YUAN; Lin LIU; Le LUO; Xiaoping LI; Sanbin WANG; Shiqi LI

doi:10.16016/j.2097-0927.202310049

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Control effect of Dasatinib on the treatment of acute myeloid leukemia and adverse events of CD123 targeting CAR-T: a case report and literature review

Monographic Reports: Advances in diagnosis and treatment for hematological malignancies | 更新时间：2026-01-09

- Control effect of Dasatinib on the treatment of acute myeloid leukemia and adverse events of CD123 targeting CAR-T: a case report and literature review
- Journal of Army Medical University Vol. 46, Issue 4, Pages: 347-351(2024)
- 作者机构：
  
  1.650100 昆明，中国人民解放军联勤保障部队第九二〇医院血液科
  2.650500 昆明，昆明医科大学研究生院
- 作者简介：
- 基金信息：
  
  the Major Science and Technology Project of Yunnan Province-Biomedicine Project(202102AA100011)
- DOI：10.16016/j.2097-0927.202310049
  CLC： R730.53;R733.7;R979.12
- Received：13 October 2023，
  
  Revised：2023-12-22，
  
  Published：28 February 2024
- 稿件说明：
移动端阅览
Chunmin LI, Yu LI, Zhongtao YUAN, et al. Control effect of Dasatinib on the treatment of acute myeloid leukemia and adverse events of CD123 targeting CAR-T: a case report and literature review[J]. Journal of Army Medical University, 2024, 46(4): 347-351.
DOI：

Chunmin LI, Yu LI, Zhongtao YUAN, et al. Control effect of Dasatinib on the treatment of acute myeloid leukemia and adverse events of CD123 targeting CAR-T: a case report and literature review[J]. Journal of Army Medical University, 2024, 46(4): 347-351. DOI： 10.16016/j.2097-0927.202310049.

摘要

目的

初步探索靶向CD123的嵌合抗原受体T细胞(chimeric antigen receptor T cells

CAR-T)治疗复发急性髓系白血病(acute myeloid leukemia

AML)的效果及达沙替尼对靶向CD123的CAR-T治疗AML引起的不良反应的效果。

方法

收集第九二〇医院血液科2019年9月收治的1例复发AML患者资料

患者既往多线化疗后复发

入组接受靶向CD123的CAR-T治疗。观察患者治疗后的血象变化

出现粒细胞缺乏时使用达沙替尼(40 mg口服

每8小时1次)

粒细胞缺乏缓解即停用达沙替尼。观察患者治疗期间血象变化、CAR-T扩增及疾病控制情况。随访时间超过1年。

结果

患者骨髓流式检测微小残留病在CAR-T回输第30天转阴

输注CAR-T细胞后患者无病生存1年。患者回输靶向CD123 CAR-T细胞后观察到CAR-T细胞显著扩增的同时出现粒细胞缺乏及细胞因子释放综合征(cytokine release syndrome

CRS)

在使用达沙替尼后CAR-T细胞扩增受抑制并伴随血象恢复

CRS症状缓解

停止使用达沙替尼后CAR-T细胞再次扩增且血象再次下降。

结论

靶向CD123的CAR-T细胞对复发AML有一定疗效

初步显示达沙替尼对CAR-T细胞的扩增和功能具有关闭作用

并可缓解靶向CD123的CAR-T治疗引起的骨髓抑制

避免严重CRS发生。

Abstract

Objective

To preliminarily explore the efficacy of chimeric antigen receptor T cells (CAR-T) targeting CD123 in the treatment of acute myeloid leukemia (AML) and the role of dasatinib in the treatment of CD123 targeting CAR-T induced side effects.

Methods

Clinical data of 1 patient with relapsed AML admitted to No.920 Hospital of PLA Joint Logistic Support Force in September

2019 were collected.The patient relapsed after previous multi-line chemotherapy and was treated with CD123 targeting CAR-T therapy.The routine blood changes of the patient after treatment were observed.Dasatinib was used when agranulocytosis occurred

40 mg orally 3 times per day

and was stopped when agranulocytosis was relieved.Changes in blood cells

CAR-T amplification

and disease control were observed.The patient was followed up for over 1 year.

Results

Flow cytometry for bone marrow showed that minimal residual disease negative result was observed in 30 d after infusion.The patient remained disease-free for over 1 year.After CD123 CAR-T cells infusion

significant expansion of CAR-T cells was observed

accompanied by granulocyte deficiency and cytokine release syndrome (CRS).After using dasatinib

inhibition of CAR-T cell expansion was observed

accompanied by blood cell recovery

and CRS symptoms were alleviated.After stop of dasatinib

CAR-T cells expanded again and blood cells decreased again.

Conclusion

CAR-T cells targeting CD123 have certain efficacy in the treatment for relapsed AML.Dashatinib has a blocking effect on the amplification and function of CAR-T

which can alleviate bone marrow suppression caused by CD123 targeting CAR-T and avoid severe CRS.

关键词

Keywords

references

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