Relapsed/Refractory Acute Myeloid Leukemia(AML) Clinical Trial
Official title:
The Prospective, Multi-center And Single-arm Clinical Study of Chimeric Antigen Receptor T(CAR-T) Cells Therapy in Relapsed/Refractory Acute Myeloid Leukemia
Acute myeloid leukemia (AML) is a group of genetically highly heterogeneous malignant disease . The disease is the most common type of adult acute leukemia. Overall survival (OS) was less than 50% in 5 years. Chimeric Antigen Receptor-transduced T cell (CAR-T) therapy is one of revolutionary targeted immunotherapy. The efficacy of CAR-T cells for the treatment of acute B lymphocytic leukemia has been widely recognized, although it start late, several clinical trials have been register in ClinicalTrials.gov.
Acute myeloid leukemia (AML) is a group of genetically highly heterogeneous malignant disease ,its' character is immature myeloid protocel abnormal differentiation and proliferation in the bone marrow. The disease is the most common type of adult acute leukemia, Overall survival (OS) was less than 50% in 5 years. Chimeric Antigen Receptor-transduced T cell (CAR-T) therapy is one of revolutionary targeted immunotherapy. CAR - T cells are taken in the form of genetic modification, and specific identified target antigen monoclonal antibody of single variable region (scFv) expression in T cell surface, and coupled with the activation of intracellular proliferation signal domain.When scFv recognizes antigens expressed in malignant cells, it stimulates the activation signal of downstream T cells and produces specific killing effects. CAR-T therapy is one of revolutionary targeted immunotherapy.The efficacy of CAR-T cells for the treatment of acute B lymphocytic leukemia has been widely recognized, although it start late, several clinical trials have been register in ClinicalTrials.gov. The cluster of differentiation (CD) antigen serves as the target for identification and research in the immuno-phenotype detection of cells.As the surface markers of immune typing, CD molecules can be used as cell identification for expression types and levels on the cell surface.Cell surface of AML has a specific type of CD molecule expression,such as cluster of differentiation antigen 33(CD33),cluster of differentiation 38(CD38),cluster of differentiation 56 (CD56), cluster of differentiation 123(CD123), cluster of differentiation 117(CD117), cluster of differentiation 133(CD133), cluster of differentiation 34(CD34) and Mucl.Therefore, it provides some good targets for the immunotherapy of CAR T cells.In AML cells and mouse model,some studies have confirmed anti-CD33 CAR-T and anti-CD123 CAR-T with good similar lethality, but the toxicity of CAR-T to myeloid hematopoietic stem/progenitor cells and mononuclear cells is widespread.In comparison,CD123 CAR-T Off-target effects slighter than CD33 CAR-T. In order to lay a foundation for the application of relapsed/refractory AML patients with CAR-T therapy，objects are refractory/ relapsed patients with AML,and plans to into the group of the number of cases in 50 cases.The main content is safety, efficacy and feasibility analysis of the CAR-T cells （single CAR-T or double CAR-T cells with CD33,CD38,CD56,CD123,CD117,CD133,CD34 or Mucl ) in the treatment of refractory/relapsed AML. ;