title: [Chimeric antigen receptors T cells in treatment of a relapsed pediatric acute lymphoblastic leukemia, relapse after allogenetic hematopoietic stem cell transplantation: case report and review of literature review].
abstract: OBJECTIVE
  To evaluate the safety and efficacy of chimeric antigen receptors T cells (CAR-T) in childhood acute B lymphoblastic leukemia (B-ALL).
  
  
  METHODS
  A relapsed B-ALL child after allogeneic hematopoietic stem cell transplantation (allo-HSCT) was treated with CAR-T, and the related literatures were reviewed.
  
  
  RESULTS
  An 11-year-old girl with TEL-AML1 fusion gene positive BALL who suffered a bone marrow relapse 28 months after remission from conventional chemotherapy. During the second remission, the patient received haploidentical allo-HSCT. She relapsed with detectable TEL-AML1 fusion gene even after chemotherapy and donor leukocyte infusions. She received an experimental donor-derived fourth generation CD19 CAR-T therapy. After infusion of 1 × 10(6)/kg CAR-T cells, she experienced only mild or moderate cytokine-release syndrome and the minimal residual disease turned negative. Then three maintenance of CAR-T cell infusions [(0.83-1.65)×10(6)/kg] was administered, and the disease-free survival had lasted for 10 months. However, the TEL-AML1 copies in her blood still increased and she died with leukemia relapse after additional CAR-T cell infusion.
  
  
  CONCLUSIONS
  Treatment of relapsed B-ALL with the fourth generation CAR-T cells directed against CD19 was effective and safe. CAR-T therapy is a novel therapeutic approach that could be useful for patients with relapsed and refractory B-ALL who have failed all other treatment options.
authors.affiliation: Pediatrics Department, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Yingxi
authors.initials: Y
authors.lastname: Zuo
authors.forename: Jingbo
authors.initials: J
authors.lastname: Wang
authors.forename: Aidong
authors.initials: A
authors.lastname: Lu
authors.forename: Yueping
authors.initials: Y
authors.lastname: Jia
authors.forename: Jun
authors.initials: J
authors.lastname: Wu
authors.forename: Lujia
authors.initials: L
authors.lastname: Dong
authors.forename: Lungji
authors.initials: L
authors.lastname: Chang
authors.affiliation: Pediatrics Department, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Leping
authors.initials: L
authors.lastname: Zhang
mesh_terms: D001853:Bone Marrow; D002648:Child; D050676:Core Binding Factor Alpha 2 Subunit / Q000235:genetics; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D018365:Neoplasm, Residual; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000628:therapy; D011948:Receptors, Antigen, T-Cell / Q000235:genetics*; D012008:Recurrence; D012074:Remission Induction; D013601:T-Lymphocytes / Q000166:cytology*; D014184:Transplantation, Homologous; D000097764:ETS Translocation Variant 6 Protein
chemical_list: D050676:Core Binding Factor Alpha 2 Subunit; D015514:Oncogene Proteins, Fusion; D011948:Receptors, Antigen, T-Cell; C102421:TEL-AML1 fusion protein; D000097764:ETS Translocation Variant 6 Protein