case_images: PMC10510403_01
case_images: The time line and key events of allogeneic CAR-T bridging HSCT treatment in children with disease progression. After a series of chemotherapy and autologous CAR-T treatments, the disease eventually progressed. On day 0, the patient was infused with allogeneic CD20/CD22 CAR-T cells after conditioning chemotherapy (FLU and CTX were used as pretreatment on day -4 to day -3). The tumor disappeared on day 53. After he had complete remission, he was bridged to allogeneic HSCT on day 55. The allogeneic CAR-T-cell preparation protocol is illustrated inside the dotted lines.
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case_images: PMC10510403_01_fimmu-14-1219872-g001.jpg
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case_images: A month and a half after tumor recurrence, CD20/CD22 allogeneic CAR-T cells were infused with 4.8 x 106/kg ( Figure 1 ).
case_images: The allogeneic CAR-T treatment outcomes. (A) The changing trend of C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), and interferon gamma (IFNgamma) after allogeneic CAR-T cell therapy. Changes in blood cells before and after HSCT. (*Granulocyte Colony-Stimulating Factor (G-CSF) was infused from day 55 to day 80.). (B) Changes in the chimerism of donor cells after allogeneic CAR-T cell therapy. (C) Changes in the number of copies of CAR-T cells after allogeneic CAR-T cell therapy. (*The copies of CAR-T cells less than 30*103/ug: CAR-T cells have almost disappeared in the patient.).
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case_images: PMC10510403_01_fimmu-14-1219872-g002.jpg
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case_images: The IL-6 level reached 12,780 pg/ml on day 1 ( Figure 2A ), and gradually stabilized after 14 days of treatment with active anti-inflammatory drugs such as tocilizumab and dexamethasone. However, due to continuous pancytopenia, there was still no sign of hematopoiesis recovery more than a month after CAR-T ( Figure 2A ). T cells were from the donor ( Figure 2B ); peripheral blood stem cell transplantation was performed from the same donor without any conditioning. The donor was mobilized by infusing G-CSF for 5 days before transplantation, and the quantity of the graft was 205ml (about 10grams) in total.