Blood: CD19 targets the prognostication and related factors of secondary infusion of CAR T cells for the treatment of incurable B-cell malignant tumors.

CD19 Targeted Chilay Antigen Subject Engineering (CD19 CAR) T-cell therapy showed significant efficacy for recurring or refractic (R/R) B-cell malignancies.
, HOWever, CD19 CAR T cells do not induce lasting remission in most patients.
secondary infusion CD19 CAR T cells (CART2) is considered a possible way to improve prognostication.
in this study, the researchers analyzed data from 44 patients with R/R B cell malignancies (ALL 14, CLL 9, NHL 21) who were treated with CART2 in a Phase 1/2 trial.
the occurrence of adverse reactions after
cart2 and CART1, although the dose of CART2 increased in 82% of patients, the researchers observed a low rate of severe toxicity response after CART2 (≥3 CRS: 9%; ≥3 neurotoxicity: 11%).
22% of ALL, 19% of NHL and 21% of ALL patients were fully relieved after receiving PFS and OS prognostics after CART2.
33 months, 6 months and 4 months after receiving CART2 in patients with CLL, NHL, and ALL.
the addition of fluorodarabin and CART2 doses to the lymphatic removal of cyclophosphamide prior to CART1 were associated with higher total remission rates and longer progression-free lifetimes after CART2.
patients who received Cy-Flu lymphatic removal prior to CART1 and had a higher dose of CART2 than CART1 had better durability of CAR T cells after CART2.
In summary, this study identifies two independent interventionable factors related to better prognostication of CART2, provides recommendations for improving the strategy of in vivo CAR T cell dynamics and remission duration after repeated CAR T cell infusion, and is instructive for the experimental design of new CAR T cell products after the failure of CAR T cell immunotherapy.
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