title: Co-infusion of haplo-identical CD19-chimeric antigen receptor T cells and stem cells achieved full donor engraftment in refractory acute lymphoblastic leukemia.
abstract: Elderly patients with relapsed and refractory acute lymphoblastic leukemia (ALL) have poor prognosis. Autologous CD19 chimeric antigen receptor-modified T (CAR-T) cells have potentials to cure patients with B cell ALL; however, safety and efficacy of allogeneic CD19 CAR-T cells are still undetermined.
  
  
  
  We treated a 71-year-old female with relapsed and refractory ALL who received co-infusion of haplo-identical donor-derived CD19-directed CAR-T cells and mobilized peripheral blood stem cells (PBSC) following induction chemotherapy. Undetectable minimal residual disease by flow cytometry was achieved, and full donor cell engraftment was established. The transient release of cytokines and mild fever were detected. Significantly elevated serum lactate dehydrogenase, alanine transaminase, bilirubin and glutamic-oxalacetic transaminase were observed from days 14 to 18, all of which were reversible after immunosuppressive therapy.
  
  
  
  Our preliminary results suggest that co-infusion of haplo-identical donor-derived CAR-T cells and mobilized PBSCs may induce full donor engraftment in relapsed and refractory ALL including elderly patients, but complications related to donor cell infusions should still be cautioned.
  
  
  
  Allogeneic CART-19 for Elderly Relapsed/Refractory CD19+ ALL. NCT02799550.
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Cai
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Guo
authors.affiliation: Department of Immunology/Department of Bio-therapeutic, Institute of Basic Medicine, School of Life Sciences, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Immunology/Department of Bio-therapeutic, Institute of Basic Medicine, School of Life Sciences, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
authors.forename: Yajing
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Immunology/Department of Bio-therapeutic, Institute of Basic Medicine, School of Life Sciences, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
authors.forename: Yelei
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Immunology/Department of Bio-therapeutic, Institute of Basic Medicine, School of Life Sciences, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
authors.forename: Hanren
authors.initials: H
authors.lastname: Dai
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Changlin
authors.initials: C
authors.lastname: Yu
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Qiyun
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Jianhui
authors.initials: J
authors.lastname: Qiao
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Kaixun
authors.initials: K
authors.lastname: Hu
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Hongli
authors.initials: H
authors.lastname: Zuo
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Dong
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Zechuan
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Mingxing
authors.initials: M
authors.lastname: Feng
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Bingxia
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Yujing
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Tieqiang
authors.initials: T
authors.lastname: Liu
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Zhiqing
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Yajing
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Yao
authors.affiliation: Department of Immunology/Department of Bio-therapeutic, Institute of Basic Medicine, School of Life Sciences, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Han
authors.affiliation: Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China. huishengai@163.com.
authors.forename: Huisheng
authors.initials: H
authors.lastname: Ai
mesh_terms: D000368:Aged; D018941:Antigens, CD19 / Q000276:immunology*; D005260:Female; D006085:Graft Survival; D006239:Haplotypes; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D016219:Immunotherapy, Adoptive / Q000009:adverse effects / Q000379:methods*; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D011948:Receptors, Antigen, T-Cell / Q000276:immunology*; D016879:Salvage Therapy / Q000379:methods; D013234:Stem Cells / Q000166:cytology; D013601:T-Lymphocytes / Q000276:immunology* / Q000637:transplantation; D016896:Treatment Outcome
chemical_list: D018941:Antigens, CD19; D011948:Receptors, Antigen, T-Cell
keywords: Allogeneic anti-CD19 chimeric antigen receptor (CAR) T cells; B cell acute lymphoblastic leukemia (B-ALL); Case report; Haplo-identical mobilized peripheral blood stem cell infusion; Relapsed and refractory