case_images: PMC7268154_01
case_images: Clinical responses of co-infusion of haploidentical CART cells and GPBMCs in two patients with advanced CD19+ ALL. (a) In Patient 1, the proportion of donor engraftment was 62%, 89%, and 100% on day 7, 14, and 21, respectively. The copy numbers of CART cells in the peripheral blood were 547, 818, and 4962 per microg of gDNA on day 7, 35, and 90, respectively, after transplant. The percentages of CD19+ cells in the peripheral blood dropped to 0.1% on day 14. CSF examination on day 14 showed 64% of CD19+ cells and 263 per microg of gDNA of CART cells, respectively. After intrathecal injection, CD19+ cells dropped to 0% and copy numbers of CART cells in the CSF maintained between 207 and 1894 per microg of gDNA. (b) Patient 1 experienced dramatic elevation of cytokine levels, especially IL-6 and IL-8, after treatment. (c) Patient 1 developed a significant elevation of C-reaction protein, alanine transaminase, and total bilirubin after treatment. (d) In Patient 2, donor engraftment in the peripheral blood was 87% on day 7 and 100% on day 14. CART copy numbers in the peripheral blood were 550 per microg of gDNA on day 4, 2499 per microg of gDNA on day 14, and fluctuated between 286 and 1334 per microg of gDNA 21-120 days after treatment. CD19+ cells in the peripheral blood dropped to 0% on day 14 and persisted from 0% to 0.25% 21-120 days after treatment. (e) Patient 2 experienced significant elevations of sIL-2R, IL-6, IL-8, and IL-10 after treatment. (f) Patient 2 developed a significant elevation of C-reaction protein, alanine transaminase, and total bilirubin after treatment.. ALT, alanine transaminase; CSF, cerebrospinal fluid; gDNA, genomic DNA; LDH, lactate dehydrogenase; PB, peripheral blood; SCRP, high sensitivity C-reaction protein; T-BIL, total bilirubin.
case_images: 10.1177_1758835920927605-fig1.jpg
case_images: PMC7268154_02_10.1177_1758835920927605-fig1.jpg
case_images: fig1-1758835920927605
case_images: HLA 5/10 matched mother (Table 1) following the reinduction chemotherapy. He developed Grade III CRS associated with dramatic cytokine elevation during days 4-14 and had a good response to treatment from ruxolitinib and tocilizumab (Figure 1e and 1f). Leukemic cells in the bone marrow dropped to 0% on day 14 and CD19+ cells in the peripheral blood also dropped to 0% on day 14 and persisted from 0% to 0.25% for 21-120 days after treatment (Figure 1d).
case_images: PMC7268154_02
case_images: Clinical responses of co-infusion of haploidentical CART cells and GPBMCs in two patients with advanced CD19+ ALL. (a) In Patient 1, the proportion of donor engraftment was 62%, 89%, and 100% on day 7, 14, and 21, respectively. The copy numbers of CART cells in the peripheral blood were 547, 818, and 4962 per microg of gDNA on day 7, 35, and 90, respectively, after transplant. The percentages of CD19+ cells in the peripheral blood dropped to 0.1% on day 14. CSF examination on day 14 showed 64% of CD19+ cells and 263 per microg of gDNA of CART cells, respectively. After intrathecal injection, CD19+ cells dropped to 0% and copy numbers of CART cells in the CSF maintained between 207 and 1894 per microg of gDNA. (b) Patient 1 experienced dramatic elevation of cytokine levels, especially IL-6 and IL-8, after treatment. (c) Patient 1 developed a significant elevation of C-reaction protein, alanine transaminase, and total bilirubin after treatment. (d) In Patient 2, donor engraftment in the peripheral blood was 87% on day 7 and 100% on day 14. CART copy numbers in the peripheral blood were 550 per microg of gDNA on day 4, 2499 per microg of gDNA on day 14, and fluctuated between 286 and 1334 per microg of gDNA 21-120 days after treatment. CD19+ cells in the peripheral blood dropped to 0% on day 14 and persisted from 0% to 0.25% 21-120 days after treatment. (e) Patient 2 experienced significant elevations of sIL-2R, IL-6, IL-8, and IL-10 after treatment. (f) Patient 2 developed a significant elevation of C-reaction protein, alanine transaminase, and total bilirubin after treatment.. ALT, alanine transaminase; CSF, cerebrospinal fluid; gDNA, genomic DNA; LDH, lactate dehydrogenase; PB, peripheral blood; SCRP, high sensitivity C-reaction protein; T-BIL, total bilirubin.
case_images: 10.1177_1758835920927605-fig1.jpg
case_images: PMC7268154_02_10.1177_1758835920927605-fig1.jpg
case_images: fig1-1758835920927605
case_images: HLA 5/10 matched mother (Table 1) following the reinduction chemotherapy. He developed Grade III CRS associated with dramatic cytokine elevation during days 4-14 and had a good response to treatment from ruxolitinib and tocilizumab (Figure 1e and 1f). Leukemic cells in the bone marrow dropped to 0% on day 14 and CD19+ cells in the peripheral blood also dropped to 0% on day 14 and persisted from 0% to 0.25% for 21-120 days after treatment (Figure 1d).