Overview
- Brief Summary: Cluster of differentiation 19 (CD19) is expressed on B cells. CD19+ tumor
cells in patients with non-Hodgkin lymphoma and acute lymphoblastic leukemia can be
targeted using T cells expressing CD19-specific chimeric antigen receptor (CAR).
- Objective: This study aims to evaluate the safety and efficacy of single-dose anti-CD19 CAR T-cell therapy in the treatment of relapsed/refractory CD19+ non-Hodgkin lymphoma and acute lymphoblastic leukemia.
- Eligibility: People aged 1 to 60 years with relapsed/refractory CD19+ non-Hodgkin lymphoma and acute lymphoblastic leukemia.
- Design: Phase 1 clinical trial, uncontrolled, single dose of CD19 CAR T-cells.
Description
- Objectives
-
- Evaluate the frequency and severity of adverse events and serious adverse events (AEs/SAEs) of the therapy.
- Evaluate the response rate after CD19 CAR T-cell infusion according to the following
- criteria
- Proportion of patients with complete response and partial response after CD19 CAR T-cell infusion
- Progression-free survival (PFS) after infusion of CD19 CAR T-cells
- Event-free survival (EFS) after infusion of CD19 CAR T-cells
- Overall survival (OS) after infusion of CD19 CAR T-cells
Eligibility
Inclusion criteria:
- B-cell acute lymphoblastic leukemia: refractory to two cycles of chemotherapy, relapsed after chemotherapy, or hematopoietic stem cell transplantation.
- B-cell non-Hodgkin lymphoma: refractory to two lines of chemotherapy, relapsed after chemotherapy, or hematopoietic stem cell transplantation.
- Age: From 1 to 60 years old (both males and females)
- Adequate organ functions:
- Serum creatinine ≤ 1.5 x ULN or eGFR ≥ 60 mL/min/1.73 m2
- ALT and AST ≤ 5 x ULN; Bilirubin ≤ 2.0 mg/dl
- No chronic lung diseases, such as obstructive pulmonary disease or bronchial asthma, required continuous medications without respiratory failure (SpO2 oxygen saturation > 92% at room temperature).
- No arrhythmia, no intracardiac thrombus or vascular wall, no heart failure, LVEF ≥ 45%
- Blood test:
- Absolute neutrophil count (ANC) ≥ 1,000/mm3 (1 G/l) without filgrastim
- Absolute lymphocyte count ≥ 100/mm3 (0.1 G/l)
- Absolute platelet count ≥ 75,000/mm3 (75 G/l)
- Hemoglobin ≥ 8.0 g/dl
- Positive for CD19 measured by immunohistochemistry or flow cytometry.
- Agree to participate in the study
- Agree to use safe methods of contraception for female patients.
Exclusion criteria:
- Involved central nervous system invasion at the time of screening.
- Medical history of veno-occlusive disease (VOD).
- Required acute treatment due to tumors such as intestinal obstructions, vascular compression, or respiratory failure.
- Having active hemolytic anemia.
- Diagnosed with primary immunodeficiency.
- Medical history of autoimmune neurological diseases or neuromyelitis.
- Receiving immunosuppressive medication, except for ≤ 30 mg prednisolone or equivalent at the time of CAR-T-cell transfusion.
- Having acute, progressive, or chronic graft-versus-host disease (GvHD).
- Having active infectious diseases determined by clinical, imaging, or other laboratory tests (blood culture, PCR, etc.)
- Patients who are critically ill or at risk of premature death characterized by:
- Acute liver failure requiring dialysis
- Heart failure requiring vasopressors
- Systemic infection unresponsive to antibiotics
- ECOG performance status ≥ 3 points at the time of screening
- Having other severe concomitant diseases (e.g., uncontrolled arterial hypertension,
heart failure NYHA III-IV).
- Unstable angina within 3 months prior to screening.
- Any previous or concurrent malignancy was not B-cell lymphoma or B-ALL.
- Medical history of clinically relevant central nervous system disease, such as epilepsy, convulsions, paralysis, aphasia, uncontrolled cerebrovascular disease, traumatic brain injury, and Parkinson's disease.
- Intolerance to excipients from cellular products.
- Pregnant women or those who expect to be pregnant or reastfeeding.
- Other diseases or other conditions and circumstances that, according to the investigator's assessment, make it difficult to ensure compliance with study treatment.
- Participation in another clinical trial at the time of screening