Summary of the treatments.
First HSCT | CART | Second HSCT | ||
---|---|---|---|---|
1 | Pretreatment HSCT/CART | 1. Modified GMALL induction | 3. Nilotinib (400 mg) twice daily | 4. FLAG-Ida |
1. Modified GMALL induction 2.Hyper-CVAD A/B+imatinib (600 mg) daily |
4. FLAG-Ida 5.Vincristine+dexamethasone+ ponatinib (30 mg) daily |
|||
2 | Disease status before transplantation | Molecular MRD-negative | NA | Molecular MRD-negative |
3 | Stem cell source | G-CSF-primed PBSCs | NA | G-CSF-primed PBSCs |
4 | ABO matching | Major mismatched A+ to O+ |
Matched A+ to A+ |
Matched A+ to A+ |
5 | CD34 cell/T cell dose | 3.0×106/kg | 8.5×106 chimeric T cells | 5.06×106/kg |
6 | CMV IgG status | Both positive | Both positive | Both positive |
7 | Conditioning regimen | TBI-Cy | Flu-Cy | Flu-Bu (2) |
8 | GVHD prophylaxis | CSA/MMF | NA | CSA/MMF |
9 | Maintenance TKI/duration | Imatinib (600 mg) daily/ 2 years |
Nilotinib (400 mg) BD/7 months | Ponatinib (30 mg) daily/ 6 months (ongoing) |
10 | Timeline from the initial diagnosis | 5 months | 3 years | 4 years and 2 months |
11 | Complications | No GVHD | No CRS | Skin GVHD grade I and catheter-related infection |
12 | Relapse | Yes 2 years and 6 months later |
Yes 8 months later |
Yes 9 months later |
13 | Site of relapse | Bone marrow | Bone marrow | CNS |
Abbreviations: Bu, busulfan; CART, chimeric receptor antigen T cells; CMV, cytomegalovirus; CNS, central nervous system; CRS, cytokine release syndrome; CSA, cyclosporine A; Cy, cyclophosphamide; Flu, fludarabine; G-CSF, granulocyte-colony stimulating factor; GVHD, graft-versus-host disease; HSCT, hematopoietic stem cell transplantation; MMF, mycophenolate mofetil; MRD, measurable residual disease; NA, not applicable; PBSC, peripheral blood stem cell; TBI, total body irradiation; TKI, tyrosine kinase inhibitor.