Acute intestinal GVHD following donor-derived CD7-CAR-T-cell infusion in a child with Omicron COVID-19

1.INTRODUCTION。CD7 is an ideal chimeric antigen receptor(CAR)target for T-cell acute lymphocytic leukemia(T-ALL).Donor-derived CAR-T-cell therapy,as an emerging treatment strategy,shows excellent efficacy in refractory/relapsed(r/r)T-ALL,with over 90%of complete remission(CR),brings new promise to improve prognosis and survival quality,and provides more opportunities for following bridging transplantation.1 However,CD7-CAR-T-cell recipients are always immunocompromised for a number of reasons:depletion of healthy T and NK cells;the need for drugs,which are lymphodepleting,prior to CAR-T-cell therapy;a history of hematological malignancies;multiple-lines chemotherapy;and hematopoietic stem-cell transplantation(HSCT).Meanwhile,patients post donor-derived CAR-T-cell therapy are at high risk of graft-versus-host disease(GVHD)considering infusion of allogeneic cell and increase incidence of infection.