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| Therapeutic Effect of Anti CD19 Chimeric Antigen Receptor T Cells in Children with Acute B-lymphocyte Leukemia |
| LIU Yukai, LIU Qi, MA Cong, WANG Zhuqing, LIU Zhouyang, SUN Yuan |
| First-author's address: Beijing Jingdu Children's Hospital, Beijing 102208, China |
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Abstract Objective: To investigate the clinical value of anti CD19 chimeric antigen receptor T cells (CD19-CAR-T cells) in children with acute B-lymphoblastic leukemia (B-ALL). Method: The clinical data of 70 patients with recurrent B-ALL admitted to Beijing Jingdu Children's Hospital from July 2018 to July 2022 were retrospectively analyzed. According to the treatment method, 35 children treated with Cytarabine were selected as the control group, Metacortandracin combined with VDLD (Vindesine, Dexamethasone, Aspartase, Idabicin) induction therapy, and 35 children treated with CD19-CAR-T cells were selected as the observation group. The serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), the results of short-term efficacy evaluation and the occurrence of adverse reactions were compared between the two groups. Result: Before treatment, there were no significant differences in the levels of TNF-α and IL-6 between the two groups (P>0.05); after treatment, the levels of TNF-α and IL-6 in both groups were higher than those before treatment, the differences were statistically significant (P<0.05). After treatment, there were no significant differences in the levels of TNF-α and IL-6 between the two groups (P>0.05). The complete remission rate in observation group was higher than that in control group (P<0.05). There was no significant difference in the effective rate between the two groups (P>0.05). In the observation group, the adverse reactions were mainly related to cytokine release syndrome (CRS), with fever in 32 cases, hypotension in 1 case and neurotoxicity in 1 case. In the control group, hematopoietic inhibition and infection were the main adverse reactions, 3 cases of liver toxicity and 2 cases of neurotoxicity. There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: CD19-CAR-T cells are effective in the treatment of children with recurrent B-ALL, and can effectively improve the decreased levels of TNF-α and IL-6 caused by relapse, the adverse reactions are mainly CRS-related symptoms, and the clinical application should be wary of neurotoxicity and other serious side effects.
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Received: 09 December 2022
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