Allogeneic donor-derived anti-CD19 CAR T-cell is a promising therapy for relapsed/refractory B-ALL after allogeneic hematopoietic stem cell transplantation

Abstract Currently, effective and safe salvage therapies are limited among relapsed patients with acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation(allo-HSCT). Anti-CD19 CART is a promising treatment in recent years. Here we reported eleven patients with B-cell acute lymphoblastic leukemia(B-ALL) relapsed after allo-HSCT between September 2017 and October 2019.They were treated with a single infusion donor-derived anti-CD19 CAR T-cell. Eight patients(72.7%) obtained morphological remissions. Seven of them(63.6%) achieved minimal residual disease (MRD)-negative remission. The ongoing complete remission(CR) duration of two patients reached 22 months. The median OS was 9 months(range:2-22months). Only one patient with grade 1 acute graft-versus-host disease was observed. Two patients （18.2%）developed cytokine release syndrome (CRS) grade 3 or 4. This prospective study showed allogeneic donor-derived anti-CD19 CAR T-cell is an effective and safe salvage method for patients with relapsed/or refractory B-ALL after allo-HSCT. Further randomized and multicenter investigations are need to evaluate their potential role in relapsed ALL therapies after allo-HSCT.