摘要
报道苏州大学附属儿童医院血液肿瘤科于2019年5月及12月收治的2例CD19靶向的嵌合抗原受体T(CD_(19)CAR-T)细胞治疗的急性B淋巴细胞白血病(B-ALL)孤立性睾丸复发(ITR)患儿的诊疗经过及结果,探讨CD_(19)CAR-T细胞治疗相较于传统放化疗的疗效,并对相关文献进行复习。2例患儿均经细胞形态学、免疫学、细胞遗传学、分子生物学诊断为B-ALL,分别于初诊第60个月及第38个月经睾丸活检术确诊为ITR,随后行CD_(19)CAR-T细胞输注,CAR-T细胞输注数量分别为7.0×10^(6)/kg和1.5×10^(7)/kg。输注CD_(19)CAR-T细胞7~10 d后睾丸白血病细胞浸润消失,均获得完全缓解。其中例2患儿治疗后发生细胞因子释放综合征并免疫效应细胞相关性神经毒性综合征,经药物干预治疗后好转。提示CD_(19)CAR-T细胞治疗儿童ITR效果良好,或可替代睾丸切除或局部放疗成为B-ALL患儿ITR的新型治疗方法。
This study reports the diagnosis and treatment of 2 children with isolated testicular recurrence(ITR)of acute B lymphoblastic leukemia(B-ALL)treated with CD_(19)targeted chimeric antigen receptor T(CD_(19)CAR-T)cells in May and December 2019 in the Department of Hematology and Oncology,Children′s Hospital of Soochow University,and explores the efficacy of CD_(19)CAR-T cells therapy versus conventional radiotherapy and chemotherapy through literature review.Both cases were diagnosed as B-ALL by the morphologic,immunologic,cytogenetic and molecular biology methods.ITR was diagnosed by testicular biopsy at 60 months and 38 months after initial diagnosis in 2 cases,respectively.After infusion of CD_(19)CAR-T cells at 7.0×10^(6)/kg and 1.5×10^(7)/kg,respectively for 7-10 days,testicular leukemia cell infiltration disappeared and complete remission was obtained.Among them,case 2 developed cytokine release syndrome and immune effector cell-related neurotoxicity syndrome after treatment,which was improved after drug intervention.It is suggested that CD_(19)CAR-T cells are effective in the treatment of ITR in children,which may be an alternative to orchiectomy or local radiotherapy for ITR in children with B-ALL.
作者
杨琪瑜
卢俊
翟宗
陈广华
胡绍燕
陆叶
李天丹
丁朦朦
王易
Yang Qiyu;Lu Jun;Zhai Zong;Chen Guanghua;Hu Shaoyan;Lu Ye;Li Tiandan;Ding Mengmeng;Wang Yi(Department of Hematology and Oncology,Children′s Hospital of Soochow University,Suzhou 215000,China;Department of Hematology and Oncology,the First Affiliated Hospital of Soochow University,Jiangsu Institute of Hematology,Suzhou 215006,China)
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2022年第5期382-385,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
国家血液系统疾病临床医学研究中心委托课题(2020WSB05)
江苏省妇幼健康科研项目(F201815)
苏州市科技计划项目(SS2019065)
苏州市临床重点病种诊疗专项项目(LCZX202008)
苏州市"科教兴卫"青年科技项目(KJXW2019024)。
