Overview
CD19-negative B-ALL relapses after CD19 CAR T-cell treatment have occurred in some patients. CD20/CD22/CD10 is still expressed in CD19 negative B-ALL cells which means these CD molecules may become new targets in treatment of CD19-negative relapse of B-ALL. Thus sequential treatment with CD20/CD22/CD10-CART after CD19-CART treatment in relapsed/refractory B-ALL will kill and eliminate CD19 negative B-ALL cells and prolong the remission time.
Description
B-cell acute lymphoblastic leukemia is the most common type of leukemia and the prognosis of relapsed/refractory B-ALL is poor. Chimeric Antigen Receptor-transduced T cell (CAR-T) therapy is one of revolutionary targeted immunotherapy. CD19 CAR-T is the most commonly used engineered T cell in B-ALL. The treatment effect is significant and far more than traditional therapy in relapsed/refractory B-ALL. However, the remission time after CD19 CAR-T infusion is short.CD19-positive and CD19-negative B-ALL relapses after CD19 CAR T-cell treatment have occurred in some patients The cause of relapse after CAR-T infusion is minimal residual disease (MRD) which will induce CD19 negative relapse. CD20/CD22/CD10 is still expressed in CD19 negative B-ALL cells which means these CD molecules may become new targets in treatment of CD19 negative relapse of B-ALL. Thus sequential treatment with CD20/CD22/CD10-CART after CD19-CART treatment in relapsed/refractory B-ALL will kill and eliminate CD19 negative B-ALL cells and prolong the remission time.
Eligibility
Inclusion Criteria:
- Relapsed/Refractory B-ALL patients
- Did not achieve complete remission after 2 times of standard plan chemotherapy
- Relapsed after first induction chemotherapy
- Did not response to chemotherapy before HSCT or relapsed after HSCT
- Cannot receive allo-HSCT or refuse to receive allo-HSCT
- Cell phenotype is CD19 and CD20/CD22/CD10/CD70 positive (single or combined)
- Estimated survival time is more than 3 months in leukemia
- Volunteered for this clinical trail and signed a consent form
Exclusion Criteria:
- MRD was negative while the cell phenotype was CD19 expressed
- Patients with severe insufficient cardiac, pulmonary and hepatorenal functions
- Patients with severe mental illness, neurological disease or infectious disease
- Patients with GVHD was taking immunosuppressants
- Pregnant or lactating women
- Patients have received other genetic therapy products
- Transfection efficiency was less than 30%
- Any situation may do harm to the subjects or interfere the results