Novel CD19-KIRS2/Dap12-BB CAR-T Treatment for 3 Patients with Relapsed and Refractory B-Cell Tumors / 中国实验血液学杂志

OBJECTIVE@#To investigate the safety and efficacy of novel CD19-KIRS2/Dap12-BB chimeric antigen receptor T cells (CAR-T cells) in the treatment of relapsed/refractory B-cell malignancy (R/R BCM).@*METHODS@#Three patients with R/R BCM treated with novel CD19-KIRS2/Dap12-BB CAR-T cells from June 2020 to November 2020 were enrolled, including 1 case of B-cell acute lymphoblastic leukaemia (B-ALL) and 2 cases of non-Hodgkin's lymphoma (NHL), and the efficacy and adverse reactions were observed.@*RESULTS@#After CAR-T cells infusion, patient with B-ALL achieved complete remission (CR) and minimal residual disease (MRD) turned negative, and 2 patients with NHL achieved partial remission (PR). Grade 2 cytokine release syndrome (CRS) occurred in B-ALL patient, grade 1 CRS occurred in 2 NHL patients, and grade II to IV hematologic adverse reactions occurred in 3 patients, all of which were controllable and reversible. The progression-free survival (PFS) of the 3 patients was 143, 199, and 91 days, and overall survival (OS) was 282, 430, and 338 days, respectively.@*CONCLUSION@#The novel CD19-KIRS2/Dap12-BB CAR-T cells in treatment of 3 patients with R/R BCM have significant short-term efficacy and controllable adverse reactions, but the long-term efficacy needs to be further improved.

Trasplante haploidéntico de progenitores hematopoyéticos: una necesidad / Haploidentical hematopoietic transplant: a need

El trasplante de células progenitoras hematopoyéticas es una terapia potencialmente curativa para pacientes con diversas enfermedades; pero solo el 25 - 30 por ciento de estos cuenta con un hermano compatible para el sistema de antígenos leucocitarios humanos. Hace algunos años se ha desarrollado el trasplante con un solo haplotipo idéntico; el que está disponible para la mayoría de los pacientes y se ha llamado trasplante haploidéntico. Se han realizado diferentes intentos para depletar la médula de linfocitos T antes de ser infundida, debido principalmente, a la frecuencia de enfermedad injerto contra huésped en este tipo de trasplante; lo que se asocia con una mayor falla primaria de injerto y a una lenta recuperación inmune. En la actualidad se realizan varios métodos que permiten sortear estos inconvenientes, por lo que este trasplante surge como una alternativa importante para los que no tienen un hermano totalmente compatible y tiene como ventajas que permite escoger entre varios candidatos y evitar la pérdida de tiempo en búsquedas de donantes no familiares(AU)

Hematopoietic stem cell transplantation is a potentially curative therapy for patients with various diseases, but only 25- 30 percent have a compatible donor for human leukocyte antigen. A few years ago it has been developed a transplant with only one identical haplotype; which it is available for most patients, and has been called haploidentical transplantation. There have been attempts to deplete the marrow of T lymphocytes before being infused, mainly due to the presence graft-versus-host disease, and this can lead to primary graft failure and a slow immune recovery. At present, several methods to overcome these drawbacks are made, so this transplantation emerges as an important alternative for those who do not have a fully matched sibling and has the advantage that allows choosing between several candidates and prevents loss of time searching unrelated donor(AU)

Missing self by heterogeneous natural killer cells.

Some murine (YAC, P815 and SP20) and human (Molt4, Raji and HR7) tumour cell lines were (i) treated with IFN-γ for inducing enhanced expression of MHC class I antigen, or (ii) given a brief treatment with citrate buffer (pH 3.0), which resulted in denaturation of class I MHC antigens on these tumour cells. IFL-γ or acid treated tumour cells were used as unlabelled competing targets in cold target inhibition assays. The results indicated that the competing ability of acid-treated tumour cells remained unaltered, whereas IFN-γ treated tumour cells competed with significantly less efficiency. These results have been evaluated in light of the current view of NK cell development and the expression of inhibitory receptors for MHC class I molecules (IRMs), on NK cells. A modified view on NK cell heterogeneity based upon IRM expression has been proposed which reconciles several apparently discordant observations about the activity and role of NK cells. Two classes of NK cells have been proposed. Type I NK ceils have target recognition receptors which do not recognize autologous normal cells, lack IRMs, and may participate in first line of defence against transformed cells in vivo. Type II NK cells have target recognition receptors for autologous normal cells and express at least one selfreactive IRM in order to prevent auto-killing. Type II NK cells participate in killing those transformed cells which down-regulate their MHC class I expression in order to escape cytotoxic T-cell surveillance. It is also postulated that mechanism of inverse correlation of target cell MHC class I expression levels and their susceptibility to NK cells, involves interference model of missing self hypothesis for type I NK cells and inhibitory signal model of missing self hypothesis for type II NE cells. Finally, it is proposed that acid treatment of tumour cells enhances their lysis susceptibility by making them additionally susceptible to type II NK cells, rather than enhancing their killing by type I NK cells. This proposition would explain the lack of effect of acid treatment on the competing ability of tumour cells, when target cells are only lysed by type I NE cells.