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ASH Newsletter Director Shuangyou LIU, on behalf of Beijing Boren Hospital, reported that sequential CD19- and CD22-CART cell therapies achieved a relapse-free survival rate up to 68.8% in the treatment of relapsed B-ALL after transplantation

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(December 1, San Diego, California, USA) The 60th Annual Conference of the American Society of Hematology (ASH) was held in San Diego, California, USA. This is the annual event in the global hematology field, attracting more than 25,000 clinicians, scientific researchers, medical students and other professionals around the world every year. The content discussed and published in the conference includes the most authoritative and the hottest researches and clinical applications in the world, and cellular immunotherapy is undoubtedly a hot topic in ASH 2018.

Director Shuangyou LIU, submitted a report to the ASH 2018 on behalf of Beijing Boren Hospital, which was selected as a poster report in the conference. Title of this clinical study: "Sequential CA19- and CD22-CART Cell Therapies for Relapsed B-Cell Acute Lymphoblastic Leukemia after Allogeneic Hematopoietic Stem Cell Transplantation".

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Photo of Director Shuangyou LIU in front of the poster

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Interview with Director Shuangyou LIU

Director Shuangyou LIU mentioned in the report that relapsed B-ALL after allo-HCT has very poor prognosis after traditional treatment, including discontinuation of immunosuppressive agents, chemotherapy, donor lymphocyte infusion (DLI) and interferons. CART cell therapy targeting CD19 has been proven to have significant efficacy on refractory/relapsed B-ALL (rrB-ALL), but single-target CART therapy may still lead to relapse, and it is difficult to maintain long-term remission. In recent years, CART therapy targeting CD22 has also shown good efficacy on rrB-ALL. Therefore, we used sequential CART therapies specifically targeting CD19 and CD22 to treat relapsed B-ALL after allo-HCT, expecting to improve the long-term relapse-free survival rate.

From June 30, 2017 to May 31, 2018, a total of 24 patients who relapsed after transplantation were included in the study. Their leukemia cells were confirmed by flow cytometry to simultaneously express CD19 and CD22 antigens; the median age of the patients was 24 years old (range: 2.3-55 years old); 17 patients had bone marrow relapse, 6 had intramedullary and extramedullary relapse, and 1 had only extramedullary relapse; 14 patients received other treatments, such as chemotherapy, donor lymphocyte infusion and interferons, or received CD19-CART therapy in other hospitals after relapse.

This clinical study preliminarily showed that for relapsed B-ALL after transplantation, after a single CD19 or CD22-CART therapy, 83.3% of patients achieved complete remission (CR); after sequential CD19- and CD22-CART therapies and median 6.5 (4-10) months of follow-up, the 6-month overall survival (OS), leukemia-free survival (LFS) and minimal residual disease (MRD)-negative LFS was 100%, 81.3% and 68.8%, respectively.

Comments of the corresponding author, Director Chunrong TONG:

Relapsed B-ALL after allo-HCT was difficult to cure in the past, especially in those with no response to various treatments of relapse after allo-HCT. It is close to the end stage, and it can be said that it will almost be “completely annihilated”.

Internationally, a 10% increase in the survival rate in patients with advanced tumors has been a breakthrough, and many new anti-tumor drugs will be approved even if they only extend the life of patients by 2-4 months.

In contrast, our team used sequential CD19- and CD22-CART therapies for the treatment of relapsed B-ALL after allo-HCT and achieved a MRD-free relapse rate of 68.8%, which was arguably a “creation”, and the overall cure rate was expected to exceed 50%. This data included all patients whom we were not experienced in at the beginning. We have already explored the experience and methods and constantly improved the treatment, and we will certainly further improve the cure rate. We will continue to publish the progress of this study at home and abroad.

Founded in 1958, the American Society of Hematology (ASH) is currently the world's largest professional organization of hematology. At this year's ASH conference, Beijing Boren Hospital and Nanfang Chunfu Children's Institute of Hematology & Oncology of the Gaobo Healthcare Group attracted the attention by two poster reports and one speech.