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达沙替尼对靶向CD123的CAR-T治疗AML及不良反应的控制作用1例报告及文献复习
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
- 陆军军医大学学报 2024年46卷第4期 页码：347-351
- 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：
[黎诗琦，E-mail：Lystch@outlook.comLI Shiqi, E-mail: Lystch@outlook.com
- 基金信息：云南省重大科技专项-生物医药专项(202102AA100011)
DOI：10.16016/j.2097-0927.202310049
中图分类号： R730.53;R733.7;R979.12收稿：2023-10-13，
修回：2023-12-22，
纸质出版：2024-02-28
- 稿件说明：
移动端阅览
李春敏, 李玉, 袁忠涛, 等. 达沙替尼对靶向CD123的CAR-T治疗AML及不良反应的控制作用1例报告及文献复习[J]. 陆军军医大学学报, 2024,46(4):347-351.
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.
李春敏, 李玉, 袁忠涛, 等. 达沙替尼对靶向CD123的CAR-T治疗AML及不良反应的控制作用1例报告及文献复习[J]. 陆军军医大学学报, 2024,46(4):347-351. DOI： 10.16016/j.2097-0927.202310049.
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
2
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
2
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
2
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
2
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
2
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
2
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
2
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
2
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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