AI Article Synopsis
- Donor cell-derived leukemia (DCL) is a challenging relapse that occurs in some patients after allogeneic hematopoietic stem cell transplantation, often resulting in poor outcomes due to resistance to standard treatment.
- A specific case of a patient with DCL (acute lymphoblastic leukemia) after umbilical cord blood transplantation showed no response to initial chemotherapy but achieved complete remission with anti-CD19 CAR-T cell therapy, although minimal residual disease (MRD) levels later increased.
- The patient was then treated with interferon-α to prevent recurrence, and has maintained remission for 41 months, indicating that combining CAR-T therapy with subsequent interferon-α may be an effective approach for treating DCL.
Article Abstract
Donor cell-derived leukemia (DCL) is a special type of relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Patients with DCL generally have a poor prognosis due to resistance to conventional chemotherapy. Here, we report a case of donor cell-derived acute lymphoblastic leukemia after umbilical cord blood transplantation. The patient didn't respond to induction chemotherapy. She then received anti-CD19 CAR-T cell therapy and achieved MRD-negative complete remission (CR). However, MRD levels rose from negative to 0.05% at 5 months after CAR-T cell therapy. Higher MRD levels were significantly associated with an increased risk of leukemia recurrence. Afterward, preemptive interferon-α treatment was administrated to prevent disease recurrence. To date, the patient has maintained MRD-negative CR for 41 months. Our results suggested that anti-CD19 CAR-T cells followed by interferon-α therapy are effective in treating donor cell-derived acute lymphoblastic leukemia. This report provides a novel strategy for the treatment of DCL.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9731404 | PMC |
| http://dx.doi.org/10.3389/fonc.2022.1021786 | DOI Listing |
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