PMC7457525_01
Temperature, serum levels of cytokines and CRP of the patient after CAR T cells infusions. a After the first CAR T cells infusion. b After the second CAR T cells infusion
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Fig1
Additionally, a series of PB cytokines, including interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor, interferon-gamma, and IL-17A levels, showed no significant increase; only C-reactive protein (CRP) showed a maximum fold change of 10 on day 22 (Fig. 1a). Cytokine and CRP levels increased slightly, indicating grade 1 CRS (Fig. 1b).
Copies of CD19-specific CAR-T cells in the peripheral blood/bone marrow of the patient after CAR-T cells infusions. Abbreviation: PB, peripheral blood; BM, bone marrow. a. CD19-CAR T cell copies from peripheral blood mononuclear cells after the first infusion. b. CD19-CAR-T cell copies from bone marrow mononuclear cells after the first infusion. c.CD19-CAR-T cell copies from peripheral blood mononuclear cells after the second infusion
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Fig2
Bone marrow examination suggested CMR 9 days after CAR-T cell infusion, and the patient maintained a state of CMR combined with persistence of CD19-directed CAR-T cells for 20 months without obvious development of graft-versus-host disease (GvHD) (Fig. 2, a and b). Meanwhile, a sharp decrease in bone marrow DNA copies of anti-CD19 CAR-T cells occurred (33.4 copies per microgram) (Fig. 2b). A positive MRD (27.8%) and SET-NUP214 transcript (231.15%) were detected, accompanied by an extremely low number of DNA copies of anti-CD19 CAR-T cells (8.05 copies per microgram) in the bone marrow specimen (Fig. 2b) and 68.7% donor cell chimerism. CAR-T cell infusion. CR, 99% donor chimerism, and significantly increased expansion and persistence of CD19-directed CAR-T cells (Fig. 2c) were achieved after infusion.