Case report: Donor-derived CLL-1 chimeric antigen receptor T-cell therapy for relapsed/refractory acute myeloid leukemia bridging to allogeneic hematopoietic stem cell transplantation after remission

Xiaojuan Miao; Yanrong Shuai; Ying Han; Nan Zhang; Yilan Liu; Hao Yao; Xiao Wang; Guangcui He; Dan Chen; Fangyi Fan; Alex H Chang; Yi Su; Hai Yi

doi:10.3389/fimmu.2024.1389227

Case report: Donor-derived CLL-1 chimeric antigen receptor T-cell therapy for relapsed/refractory acute myeloid leukemia bridging to allogeneic hematopoietic stem cell transplantation after remission

Front Immunol. 2024 May 13:15:1389227. doi: 10.3389/fimmu.2024.1389227. eCollection 2024.

Authors

Xiaojuan Miao^#¹, Yanrong Shuai^#¹, Ying Han^#¹, Nan Zhang¹, Yilan Liu¹, Hao Yao¹, Xiao Wang¹, Guangcui He¹, Dan Chen¹, Fangyi Fan¹, Alex H Chang^{2

3}, Yi Su¹, Hai Yi¹

Affiliations

¹ Department of Hematology, People's Liberation Army The General Hospital of Western Theater Command, Sichuan Clinical Research Center for Hematological Disease, Branch of National Clinical Research Center for Hematological Disease, Chengdu, Sichuan, China.
² Shanghai YaKe Biotechnology Ltd., Shanghai, China.
³ Engineering Research Center of Gene Technology, Ministry of Education, Institute of Genetics, School of Life Sciences, Fudan University, Shanghai, China.

^# Contributed equally.

Abstract

Background: Explore the efficacy and safety of donor-derived CLL-1 chimeric antigen receptor T-cell therapy (CAR-T) for relapsed/refractory acute myeloid leukemia (R/R AML) bridging to allogeneic hematopoietic stem cell transplantation (allo-HSCT) after remission.

Case presentation: An adult R/R AML patient received an infusion of donor-derived CLL-1 CAR-T cells, and the conditioning regimen bridging to allo-HSCT was started immediately after remission on day 11 after CAR-T therapy upon transplantation. Then, routine post-HSCT monitoring of blood counts, bone marrow (BM) morphology, flow cytometry, graft-versus-host disease (GVHD) manifestations, and chimerism status were performed.

Result: After CAR-T therapy, cytokine release syndrome was grade 1. On day 11 after CAR-T therapy, the BM morphology reached complete remission (CR), and the conditioning regimen bridging to allo-HSCT started. Leukocyte engraftment, complete donor chimerism, and platelet engraftment were observed on days +18, +23, and +26 post-allo-HSCT, respectively. The BM morphology showed CR and flow cytometry turned negative on day +23. The patient is currently at 4 months post-allo-HSCT with BM morphology CR, negative flow cytometry, complete donor chimerism, and no extramedullary relapse/GVHD.

Conclusion: Donor-derived CLL-1 CAR-T is an effective and safe therapy for R/R AML, and immediate bridging to allo-HSCT after remission may better improve the long-term prognosis of R/R AML.

Keywords: C-type lectin-like molecule 1; acute myeloid leukemia; allogeneic hematopoietic stem cell transplantation; donor-derived chimeric antigen receptor T cells; relapsed/refractory.

Publication types

Case Reports

MeSH terms

Adult
Female
Graft vs Host Disease / etiology
Hematopoietic Stem Cell Transplantation*
Humans
Immunotherapy, Adoptive* / adverse effects
Immunotherapy, Adoptive* / methods
Leukemia, Myeloid, Acute* / immunology
Leukemia, Myeloid, Acute* / therapy
Male
Middle Aged
Receptors, Chimeric Antigen / immunology
Remission Induction
Tissue Donors
Transplantation Conditioning / methods
Transplantation, Homologous*
Treatment Outcome

Substances

Receptors, Chimeric Antigen

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Hospital Management Research Foundation of the General Hospital of Western Theater Command (No. 2019ZY06 and No. 2021-XZYG-A07).