外周血细胞参数对CD19-CART治疗难治/复发急性B淋巴细胞白血病疗效的预测作用

The Effect of Peripheral Blood Cell Paremeters in the Patients with Refractory/Relapsed Acute B-Lymphoblastic Leukemia Treated with CD19-CAR-T Cells

目的研究外周血细胞参数在CD19-嵌合型抗原受体T细胞(CD19-CAR-T)治疗难治/复发急性B淋巴细胞白血病中的作用。方法回顾性分析2017年5月~2020年5月在北京陆道培医院接受CD19-CAR-T治疗难治/复发急性B淋巴细胞白血病患者的临床资料,比较治疗后46例CAR-T细胞治疗后微小残留病(MRD)阴性患者(MRD阴性组)和38例微小残留病阳性患者(MRD阳性组)治疗过程中的外周血细胞参数。结果MRD阴性组在CD19-CAR-T细胞回输时白细胞、血红蛋白、血小板和中性粒细胞数值,明显高于MRD阳性组患者,差异具有统计学意义(P<0.05)。MRD阴性组在回输第7天、第14天、第21天的血小板数值明显高于MRD阳性组,差异具有统计学意义(P<0.05)。结论CD19-CAR-T细胞回输时外周血细胞数值高,第7天、第14天、第21天血小板数值高,可能预示CD19-CAR-T细胞治疗有效;与化疗相比较,CD19-CAR-T细胞治疗后的造血恢复速度更快。

Objective To study the effect of peripheral blood cell paremeters in the patients with refractory/relapsed acute B-lymphoblastic leukemia treated with CD19 chimeric antigen receptor T cells(CD19-CAR-T).Methods We retrospectively analyzed the clinical data of patients with refractory/relapsed acute B-lymphoblastic leukemia treated with CD19-CAR-T cells in Beijing Ludaopei hospital from May 2017 to May 2020.The peripheral blood cell parameters were compared between 46 patients with minimal residual disease(MRD)negative(MRD negative group)and 38 patients with minimal residual disease positive(MRD positive group)after CAR-T cells therapy.Results The mean values of leukocytes,hemoglobin,platelets and neutrophils(LHPN0)in the MRD negative group were signifi cantly higher than those in the MRD positive group on the day of CAR-T cells transfusion,and the diff erencewas statistically signifi cant(P<0.05).The mean platelet values on the 7th,14th and 21st day(PLT7,PLT14,PLT21)after CD19-CAR-T cells transfusion were signifi cantly higher in the MRD negative group than those in the MRD positive group,respectively,and the diff erencewas statistically signifi cant(P<0.05).Conclusion The higher value of LHPN0,PLT7,PLT14,PLT21 may indicate that CD19-CAR-T cell treatment may be eff ective.The hematopoietic recovery is faster after CD19-CAR-T treatment than after chemotherapy.