Anti-CD19 chimeric antigen receptors T cells for the treatment of relapsed or refractory E2A-PBX1 positive acute lymphoblastic leukemia: report of three cases

Leuk Lymphoma. 2019 Jun;60(6):1454-1461. doi: 10.1080/10428194.2018.1533127. Epub 2019 Feb 4.

Abstract

Patients with relapsed or refractory E2A-PBX1 positive acute B lymphoblastic leukemia (B-ALL) receiving anti-CD19 chimeric antigen receptor T cells (CAR-T) were retrospectively assessed to evaluate the efficacy and safety of disease burden on outcomes and to identify predictive variables. Of the three case patients, case 1 relapsed after hematopoietic stem cell transplantation. After being treated with anti-CD19 CAR-T, the patient showed minimal residual disease (MRD), and his fusion genes turned negative. Case 2, who suffered refractory leukemia, received anti-CD19 CAR-T treatment in an attempt to remove the MRD before transplantation. She showed MRD, and her fusion genes turned negative. Case 3 received anti-CD19 CAR-T treatment because of relapse after allo-SCT at the molecular level. After infusion, she developed severe pneumonia accompanied with the indication that the leukemia had progressed. Our findings suggest that anti-CD19 CAR-T cells therapy with a remarkable MRD eradicating ability might be an effective option for patients with relapsed and refractory E2A-PBX1 positive B-ALL.

Keywords: Anti-CD19 chimeric antigen receptor T cells; E2A-PBX1 fusion genes; MRD eradicating; leukemia; refractory; relapse.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antigens, CD19 / immunology*
  • Biomarkers, Tumor
  • Drug Resistance, Neoplasm / genetics
  • Female
  • Homeodomain Proteins / genetics*
  • Humans
  • Immunophenotyping
  • Immunotherapy, Adoptive
  • Karyotype
  • Male
  • Oncogene Proteins, Fusion / genetics*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Receptors, Antigen, T-Cell / genetics
  • Receptors, Antigen, T-Cell / metabolism*
  • Receptors, Chimeric Antigen / genetics
  • Receptors, Chimeric Antigen / metabolism*
  • Recurrence
  • T-Lymphocytes / immunology*
  • T-Lymphocytes / metabolism*
  • Treatment Outcome

Substances

  • Antigens, CD19
  • Biomarkers, Tumor
  • Homeodomain Proteins
  • Oncogene Proteins, Fusion
  • Receptors, Antigen, T-Cell
  • Receptors, Chimeric Antigen
  • E2A-Pbx1 fusion protein