Background before CAR T-cell therapy
A 12-year-old girl was diagnosed with B-ALL 14 months ago. Bone marrow
(BM)
morphology
showed that lymphoblastic cells occupied 46%. Immunophenotype via flow
cytometry (FCM) demonstrated 51% malignant cells expressing
CD38+, CD10+,
CD19+, CD20+,
CD34+, HLA-DR+,
CD71+, and cCD79a+. Genetic
examination showed no specific fusion gene. According to CCLG 2008
protocol(12), she was classified as intermediate risk. She received five
courses of intense chemotherapy, and minimal residual disease (MRD) was
continuously positive. Three months ago, the BM test showed relapse.
Then, she received continuous strengthened chemotherapy, including
vincristine, doxorubicin, L-asparaginase, ifosfamide, and three doses of
bortezomib. The BM morphology still showed no remission. She was
diagnosed as R/R ALL and recruited to the CAR T-cell clinical trial.
This trial was registered at the Chinese Clinical Trial Registry as
study ChiCTR-OPN-17013507.