title: Anti-CD19 chimeric antigen receptor T-cell therapy for adult Philadelphia chromosome-positive acute lymphoblastic leukemia: Two case reports.
abstract: BACKGROUND
  The presence of the Philadelphia chromosome (Ph) in acute lymphoblastic leukemia (ALL) has been associated with a high risk of disease relapse and a poor prognosis. Allogeneic hematopoietic stem cell transplantation (HSCT) is an established treatment for adults with Ph-positive ALL, but relapse remains the primary cause of treatment failure, and is associated with an extremely poor prognosis. The emergence of resistance to tyrosine kinase inhibitors (TKIs) poses a challenge for patients with disease relapses after initial treatment with TKI-containing regimens.
  
  
  METHODS
  Two patients with TKI-resistant recurrent Ph-positive ALL.
  
  
  METHODS
  Ph-positive ALL.
  
  
  METHODS
  Anti-CD19 CAR T-cell infusion.
  
  
  RESULTS
  One patient's bone marrow blasts decreased significantly, and the other reached negative minimal residual disease (MRD). However, we first recorded the development of new-onset acute graft-versus-host disease (aGVHD) after anti-CD19 CAR T-cell infusion in a patient who received allogeneic HSCT. Our 2 case reports also demonstrate the efficacy of anti-CD19 CAR T-cell therapy in the treatment of TKI-resistant Ph-positive ALL.
  
  
  CONCLUSIONS
  Our report suggests that anti-CD19 CAR T-cell therapy may be a promising option for the treatment of relapsed Ph-positive ALL after conventional chemotherapy or allogeneic HSCT. However, caution is due given the possibility of the adverse effects of cytokine release syndrome (CRS)-induced aGVHD for patients receiving allogeneic HSCT.
authors.affiliation: Department of Hematology, Guangdong No. 2 Provincial People's Hospital, Guangzhou Innovative Cellular Therapeutics Co., Ltd. (Formerly SiDanSai Biotechnology Co., Ltd), Shanghai, China.
authors.forename: Yang-Min
authors.initials: YM
authors.lastname: Zhu
authors.forename: Zhao
authors.initials: Z
authors.lastname: Wu
authors.forename: You-Ping
authors.initials: YP
authors.lastname: Tan
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Du
authors.forename: Zhi
authors.initials: Z
authors.lastname: Liu
authors.forename: Rui-Ming
authors.initials: RM
authors.lastname: Ou
authors.forename: Shuang
authors.initials: S
authors.lastname: Liu
authors.forename: Cheng-Fei
authors.initials: CF
authors.lastname: Pu
authors.forename: Jing
authors.initials: J
authors.lastname: Jiang
authors.forename: Jin-Ping
authors.initials: JP
authors.lastname: Wang
authors.forename: Lei
authors.initials: L
authors.lastname: Xiao
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
mesh_terms: D000328:Adult; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D010677:Philadelphia Chromosome; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D011948:Receptors, Antigen, T-Cell / Q000276:immunology*; D016896:Treatment Outcome
chemical_list: C000605956:CD19-specific chimeric antigen receptor; D015850:Interleukin-6; D011948:Receptors, Antigen, T-Cell