Acquisition of a CD19-negative myeloid phenotype allows immune escape of MLL-rearranged B-ALL from CD19 CAR-T-cell therapy

作者：Gardner, Rebecca; Wu, David; Cherian, Sindhu; Fang, Min; Hanafi, Laila-Aicha; Finney, Olivia; Smithers, Hannah; Jensen, Michael C.; Riddell, Stanley R.; Maloney, David G.; Turtle, Cameron J.^*

来源：Blood, 2016, 127(20): 2406-2410.

DOI：10.1182/blood-2015-08-665547

• ACUTE LYMPHOBLASTIC-LEUKEMIA

Administration of lymphodepletion chemotherapy followed by CD19-specific chimeric antigen receptor (CAR)-modified T cells is a remarkably effective approach to treating patients with relapsed and refractory CD19 1 B-cell malignancies. We treated 7 patients with B-cell acute lymphoblastic leukemia (B-ALL) harboring rearrangement of the mixed lineage leukemia (MLL) gene with CD19 CAR-T cells. All patients achieved complete remission (CR) in the bone marrow by flow cytometry after CD19 CAR-T-cell therapy; however, within 1 month of CAR-T-cell infusion, 2 of the patients developed acute myeloid leukemia (AML) that was clonally related to their B-ALL, a novel mechanism of CD19-negative immune escape. These reports have implications for the management of patients with relapsed and refractory MLL-B-ALL who receive CD19 CAR-T-cell therapy.

• 出版日期2016-5-19