Acute Lymphoblastic Leukemia(T-ALL)-06

A 2-year-old pediatric patient with T-ALL achieves remission after CAR-T therapy following over ten rounds of intensive chemotherapy.

Two-year-old Xiaohong from Zhejiang was diagnosed with leukemia last summer. After more than a year of treatment, flow cytometry detected a relapse, leading the family to seek CAR-T immunotherapy at Lu Daopei Hospital.

On August 9, 2020, Xiaohong was admitted to a local children's hospital due to a "three-day fever." Bone marrow MICM examination diagnosed acute lymphoblastic leukemia (T-ALL). After one course of chemotherapy, bone marrow morphology showed complete remission, and flow cytometry detected no malignant immature cells. Subsequent intensive chemotherapy over 11 courses maintained complete remission of the bone marrow.

On September 3, 2021, a follow-up bone marrow puncture showed complete remission in morphology, but flow cytometry revealed 1.85% malignant immature cells. Seeking further treatment, Xiaohong was admitted to Yanda Lu Daopei Hospital on September 24. Upon admission, bone marrow morphology was still in complete remission, but immunophenotyping indicated 0.10% malignant immature T lymphocytes.

Considering Xiaohong's young age and the persistence of the disease despite over ten rounds of intensive chemotherapy, the medical team in the second ward of the hematology department decided that Xiaohong could enroll in the CD7 CAR-T clinical trial.

On September 30, 2021, peripheral blood cells were collected for CAR-T cell culture. On October 10, Xiaohong received FC regimen chemotherapy. On October 13, a bone marrow puncture showed less than 5% blasts in morphology, and flow cytometry indicated 0.37% malignant immature T cells. On October 15, CD7 CAR-T cells were reinfused.

On January 3 (20 days post-reinfusion), a bone marrow puncture showed complete remission in morphology, with no malignant immature cells detected by flow cytometry. Xiaohong's condition has since stabilized, and he has been transferred to the transplant department to prepare for an allogeneic hematopoietic stem cell transplant.

Xiaohong was less than one year old when he fell ill and endured over a year of drug treatment. The successful bridging to transplant after CD7 CAR-T therapy has provided a powerful weapon to completely defeat the disease.