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case_images: The trend of temperature, cytokines, CRP and ferritin levels after the first CAR-T cells infusion.
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case_images: Despite this, there were no significant fluctuations in inflammatory indicators ( Figure 2 ). In the subsequent days, both inflammatory markers and temperature started to decline and returned to normal levels by the 18th day after infusion ( Figure 2 ), indicating successful passage of the side effect stage after CAR-T treatment.
case_images: The in vivo kinetics of CAR-T cells and dynamics of CD3- CD19+ target cells. (A) Expansion and persistence of CAR-T cells shown by the CAR gene copies per mug DNA in the patient's peripheral blood. (B) Dynamics of CD3- CD19+ target cells in the patient's peripheral blood detected by flow cytometry.
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case_images: Laboratory data also revealed the in vivo kinetics of CAR-T cells and the dynamics of CD3- CD19+ target cells ( Figure 3 ). CAR-T cells commenced on Day 15 and reached its peak on Day 18 after infusion ( Figure 3A ), which correlated with the clinical symptoms observed in the patient. CSF and BM examinations conducted on Day 20, Day 25, and Day 30 after CAR-T cell infusion did not detect any residual tumor cells. Consistent with these findings, CD3- CD19+ target cells were not detected in the peripheral blood after Day 15 ( Figure 3B ). However, there was a significant decrease in CAR gene copies on Day 28, suggesting relatively poor persistence of CAR-T cells ( Figure 3A ).
case_images: Cytolytic activity of the allogeneic CAR-T cells and its non-transduced T cells control when the E (effector) to T (target) ratio is 3:1.
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case_images: Laboratory data confirmed the high anti-tumor efficacy of the CAR-T cells in vitro ( Figure 4 ).
case_images: The trend of temperature, IL-6 and CRP levels after the second CAR-T cells infusion.
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case_images: The following day, the temperature further increased, accompanied by significant elevations in IL-6 and CRP levels ( Figure 5 ), indicative of CRS reaction. Over the subsequent days, careful monitoring of the patient's temperature and inflammatory markers revealed a gradual decrease starting on Day 8 post-infusion ( Figure 5 ), with no development of discomfort.
case_images: The in vivo kinetics of donor-derived CAR-T cells and dynamics of CD3- CD19+ target cells. (A) Expansion and persistence of CAR-T cells shown by the CAR gene copies per mug DNA in the patient's peripheral blood. (B) Dynamics of CD3- CD19+ target cells in the patient's peripheral blood detected by flow cytometry.
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case_images: CAR-T cells and dynamics of CD3- CD19+ target cells were depicted in  Figure 6 . CAR-T cell expansion reached its peak on Day 11 and exhibited a slower decline compared to the allogenic infusion. CAR-T cell infusion confirmed CR and MRD negativity, indicating the effectiveness of allogeneic CAR-T treatment. Consistent with these results, CD3- CD19+ target cells were not detected in the peripheral blood after Day 11 ( Figure 6B ).