HE Mingxia,LAI Jin,WENG Yiqin, et al. Efficacy and safety of CD19-CART in the treatment of relapsed refractory non-Hodgkin’s B-cell lymphoma[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2020, 50(8): 616-622.
Abstract：Objective: To investigate the therapeutic efficacy and safety of CD19 chimeric antigen receptor T cells (CART) for the relapsed/refractory B-cell non-Hodgkin’s lymphoma (B-NHL). Methods: After close follow-up, the short-term and long-term response and adverse effect (AEs) of 10 patients with B-NHL who received CD19-CART therapy from April 2017 to October 2018 were evaluated. Results: All patients were with relapsed/refractory lymphoma. After infusion of CD19-CART cells in 10 patients, the total complete response (CR) rate was 30%, the partial response (PR) rate was 40%, and the overall response rate was 70%. In vivo proliferation of CD19-CART cells was detected in peripheral blood of all patients, which decreased rapidly after about 3 months. The median follow-up was 9 (1-24) months. The median overall survival (OS) of all patients was (10.5±4.0) months, and the median progression-free survival (PFS) was (4.6±3.9) months. A total of 8 patients (8/10) had cytokine release syndrome (CRS) after infusion of CART cells, of which five were grade 1 CRS, two were grade 2 CRS and one was grade 4 CRS accompanying with grade 4 neurotoxicity. Two patients used Tocilizumab (IL-6 receptor monoclonal antibody), and one patient was treated combined with glucocorticoids. Except for one patient suffering from grade 4 CRS who died of grade 4 neurotoxicity on the 18th day after infusion, the other patients with CRS were effectively controlled. Conclusion: Since CART therapy for relapsed/refractory CD19+ B cell lymphoma has achieved certain effect in some ways and the AEs were controllable, it could be used as a salvage treatment for relapsed/refractory patients. Timely monitoring and management of AEs during the infusion period might help prevent the uncontrollable outcomes.
