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case_images: The schema and CAR T-cell persistence in peripheral blood. Panel (A) shows treatment schema. The black triangle indicates the date of lumber puncture. Panels (B, C) show the kinetics of CAR vector transgene copies measured by quantitative PCR and CAR T cells in the peripheral blood measured by flow cytometry.
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case_images: T-cell. Therefore, allogeneic hematopoietic stem cell transplantation followed by preventive infusion of allogenic CD7 CAR T-cell from the same donor were performed ( Figure 1A ). CAR T-cell (1x106/kg) from the same donor was infused with oral tacrolimus 0.5mg every 12 h instead of lymphodepleting chemotherapy, and, at the same time, peripheral blood lymphocyte count was 0.78x109/L. CAR T-cell in the peripheral blood (PB) demonstrated peak expansion at 19 days post-infusion with 9.1x107/L and continued to be detectable post-infusion ( Figures 1B, C ). So far, the patient remains in continued CR with full donor chimerism for 20 months after HSCT assessed intermittently using the bone marrow, CSF, and PET/CT ( Figures 1A ,  5 ).
case_images: Peripheral blood cell count trends. The counts of leukocyte (A), hemoglobin (B), and platelet (C) in the peripheral blood are listed from admission to our hospital. The vertical line represents the date of CAR T cells infusion.
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case_images: T-cell infusion ( Figure 2 ). CD7-positive cells of helper and cytotoxic
case_images: The lymphocytes reconstitution in the peripheral blood. CD7-positive cells of helper (A) and cytotoxic (B) T cells in the peripheral blood dropped to zero from day +17 following CAR T-cell infusion. Panels (C, D) show CD7-negative cells of helper and cytotoxic T cells in the peripheral blood expanded from day +17 following CAR T-cell infusion. The reconstitutions of CD3+ T cells (E), CD19+ B cells (F), and CD16+/CD56+ NK cells (G) are listed. The vertical lines indicate the date of CAR T cells infusion.
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case_images: T cells in PB dropped to zero from day +17 ( Figures 3A, B ), and CD7-negative cells of helper and cytotoxic T cells in PB expanded from the same time ( Figures 3C, D ). Therefore, the gradual recoveries of CD3+ T cells, CD19+ B cells, and CD16+/CD56+ NK cells were all observed following CAR T-cell infusion ( Figures 3E-G ). The elevations of serum cytokines (IL-6, IL-8, IL-10, gamma-IFN, and TNF-alpha) were observed after HSCT and CAR T cells infusion ( Figure 4 ).
case_images: The cytokines data in the peripheral blood. The cytokines (gamma-IFN, IL-10, IL-12p70, IL-17A, IL-17F, IL-1beta, IL-2, IL-22, IL-4, IL-5, IL-6, IL-8, TNF-alpha, and TNF-beta) in the peripheral blood are listed from admission to our hospital. The vertical lines represent the date of CAR T cells infusion.
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case_images: T cells in PB dropped to zero from day +17 ( Figures 3A, B ), and CD7-negative cells of helper and cytotoxic T cells in PB expanded from the same time ( Figures 3C, D ). Therefore, the gradual recoveries of CD3+ T cells, CD19+ B cells, and CD16+/CD56+ NK cells were all observed following CAR T-cell infusion ( Figures 3E-G ). The elevations of serum cytokines (IL-6, IL-8, IL-10, gamma-IFN, and TNF-alpha) were observed after HSCT and CAR T cells infusion ( Figure 4 ).
case_images: PET/CT images in this patient. The PET/CT images were obtained at month 3 before HSCT (A), month 2 after HSCT (B) and month 13.5 after HSCT (C). Panel (A) shows the increased tracer uptake in anterior superior mediastinum and new lesions of hypermetabolic focus in the bilateral femoral head and right humeral head. Panels (B, C) demonstrate a persistent complete remission after HSCT.
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case_images: So far, the patient remains in continued CR with full donor chimerism for 20 months after HSCT assessed intermittently using the bone marrow, CSF, and PET/CT ( Figures 1A ,  5 ).