Acute Lymphoblastic Leukemia(T-ALL)-07

Patient: Amei

Gender：Female

Age: 24 years old

Nationality: Chinese

Diagnosis:Acute Lymphoblastic Leukemia(T-ALL)

A Miao girl achieves complete remission after CAR-T therapy following post-transplant relapse.

Amei, a postgraduate student from Hunan of Miao ethnicity, had published two SCI papers. On April 2, 2020, she was admitted to a provincial hospital due to recurrent fever. Bone marrow examination diagnosed her with acute lymphoblastic leukemia (T-ALL). After multiple courses of chemotherapy at the external hospital, her bone marrow remained in remission. On November 2, 2020, she underwent an allogeneic hematopoietic stem cell transplant at our hospital (brother-to-sister, HLA 7/10 match). Post-transplant, the cells engrafted successfully, and follow-up bone marrow examinations showed sustained remission.

On June 16, 2021 (7 months post-transplant), a routine check-up revealed a full relapse of her leukemia. Subsequent chemotherapy failed to control the disease, and she developed pneumonia and herpes virus infection, with painful oral ulcers making swallowing difficult. She was admitted to the second ward of the hematology department and enrolled in the CD7 CAR-T clinical trial.

Director Yang Junfang’s medical team provided active anti-infection treatment, pain relief, and extensive blood and platelet transfusions. Due to the high tumor burden (80% blasts in the bone marrow and 97% blasts in peripheral blood), it was not possible to collect her cells. Peripheral blood lymphocytes from the donor (her brother) were collected and sent to a biotech company for CAR-T cell culture.

On August 10, 2021, donor-derived CD7 CAR-T cells were reinfused. After reinfusion, the CAR-T cells expanded to 54.64% in the peripheral blood, with only fever and no significant cytokine release syndrome (CRS) or graft-versus-host disease (GVHD). Bone marrow examination on day 16 post-reinfusion showed complete remission, with 54.13% CAR-T cells in the bone marrow. At day 36, the bone marrow continued to show sustained remission. Currently, her mental state, sleep, and appetite are good, and she is recovering well.