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CASE REPORT article

Front. Immunol.
Sec. T Cell Biology
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1454614

Successful combination of CLL1 CAR-T therapy and hematopoietic stem cell transplantation in a 73-year-old patient diagnosed with refractory acute myeloid leukemia

Provisionally accepted
Yifan Zhao Yifan Zhao 1,2*Hao Wang Hao Wang 2,3Yu Zhang Yu Zhang 4Yi Zhang Yi Zhang 2Xiaomei Zhang Xiaomei Zhang 2Mohan Zhao Mohan Zhao 2Jile Liu Jile Liu 2Shujing Guo Shujing Guo 2Mingfeng Zhao Mingfeng Zhao 2,4
  • 1 College of Medicine, Shantou University, Shantou, China
  • 2 First Central Clinical College, Tianjin Medical University, Tianjin, China
  • 3 Tianjin Hospital, Tianjin, Tianjin, China
  • 4 Department of Hematology, Tianjin First Central Hospital, Tianjin, China

The final, formatted version of the article will be published soon.

    The incidence of Acute myeloid leukemia (AML) increases with advancing age, and the prognosis for elderly patients is significantly poorer compared to younger patients. Although the combination therapy of venetoclax and hypomethylating agents has demonstrated improved prognosis in patients unable to tolerate intensive chemotherapy, there remains a therapeutic blank for those who fail to achieve remission with current treatment regimens. Here, we report the successful clinical utilization of autogenous CLL1 CAR-T therapy combined with hematopoietic stem cell transplantation in a 73-year-old patient diagnosed with refractory AML. The patient achieved morphological complete remission (CR) with incomplete marrow recovery and a slight presence of minimal residual disease (MRD) after receiving CLL1 CAR-T therapy. To further enhance the treatment and promote the recovery of hemopoiesis, we performed bridged allogenic hematopoietic stem cell transplantation (allo-HSCT) 20 days after the infusion of CLL1 CAR-T cells. The patient achieved MRD-negative CR following HSCT treatment. His primary disease maintained a complete remission status during the 11-month follow-up period. The patient encountered grade 2 cytokine release syndrome and grade 4 granulocytopenia subsequent to the infusion of CAR-T cells, while several rounds of infection and graft-versus-host disease were observed following allo-HSCT.Nevertheless, all these concerns were successfully addressed through comprehensive provision of supportive treatments. We have successfully demonstrated a highly effective and safe combination strategy involving CLL1 CAR-T therapy and allo-HSCT, which has exhibited remarkable tolerability and holds great promise even for elderly patients with AML.

    Keywords: Acute Myeloid Leukemia, CLL1, Chimeric antigen receptor T cell, Hematopoietic Stem Cell Transplantation, older

    Received: 25 Jun 2024; Accepted: 02 Sep 2024.

    Copyright: © 2024 Zhao, Wang, Zhang, Zhang, Zhang, Zhao, Liu, Guo and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yifan Zhao, College of Medicine, Shantou University, Shantou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.