CD19 CAR T-Cell Therapy for R/R Non-Hodgkin Lymphoma and Acute Lymphoblastic Leukemia

Objectives:

• Evaluate the frequency and severity of adverse events and serious adverse events (AEs/SAEs) of the therapy.
• Evaluate the response rate after CD19 CAR T-cell infusion according to the following criteria:

• Proportion of patients with complete response and partial response after CD19 CAR T-cell infusion
• Progression-free survival (PFS) after infusion of CD19 CAR T-cells
• Event-free survival (EFS) after infusion of CD19 CAR T-cells
• Overall survival (OS) after infusion of CD19 CAR T-cells

Inclusion criteria

• B-cell acute lymphoblastic leukemia: refractory to two cycles of chemotherapy, relapsed after chemotherapy, or hematopoietic stem cell transplantation.
• B-cell non-Hodgkin lymphoma: refractory to two lines of chemotherapy, relapsed after chemotherapy, or hematopoietic stem cell transplantation.
• Age: From 1 to 60 years old (both males and females)
• Adequate organ functions:

• Serum creatinine ≤ 1.5 x ULN or eGFR ≥ 60 mL/min/1.73 m2
• ALT and AST ≤ 5 x ULN; Bilirubin ≤ 2.0 mg/dl
• No chronic lung diseases, such as obstructive pulmonary disease or bronchial asthma, required continuous medications without respiratory failure (SpO2 oxygen saturation > 92% at room temperature).
• No arrhythmia, no intracardiac thrombus or vascular wall, no heart failure, LVEF ≥ 45%
• Blood test:

• Absolute neutrophil count (ANC) ≥ 1,000/mm3 (1 G/l) without filgrastim
• Absolute lymphocyte count ≥ 100/mm3 (0.1 G/l)
• Absolute platelet count ≥ 75,000/mm3 (75 G/l)
• Hemoglobin ≥ 8.0 g/dl
• Positive for CD19 measured by immunohistochemistry or flow cytometry.
• Agree to participate in the study
• Agree to use safe methods of contraception for female patients.

Exclusion criteria

• Involved central nervous system invasion at the time of screening.
• Medical history of veno-occlusive disease (VOD).
• Required acute treatment due to tumors such as intestinal obstructions, vascular compression, or respiratory failure.
• Having active hemolytic anemia.
• Diagnosed with primary immunodeficiency.
• Medical history of autoimmune neurological diseases or neuromyelitis.
• Receiving immunosuppressive medication, except for ≤ 30 mg prednisolone or equivalent at the time of CAR-T-cell transfusion.
• Having acute, progressive, or chronic graft-versus-host disease (GvHD).
• Having active infectious diseases determined by clinical, imaging, or other laboratory tests (blood culture, PCR, etc.)
• Patients who are critically ill or at risk of premature death characterized by:

• Acute liver failure requiring dialysis
• Heart failure requiring vasopressors
• Systemic infection unresponsive to antibiotics
• ECOG performance status ≥ 3 points at the time of screening
• Having other severe concomitant diseases (e.g., uncontrolled arterial hypertension, heart failure NYHA III-IV).
• Unstable angina within 3 months prior to screening.
• Any previous or concurrent malignancy was not B-cell lymphoma or B-ALL.
• Medical history of clinically relevant central nervous system disease, such as epilepsy, convulsions, paralysis, aphasia, uncontrolled cerebrovascular disease, traumatic brain injury, and Parkinson's disease.
• Intolerance to excipients from cellular products.
• Pregnant women or those who expect to be pregnant or reastfeeding.
• Other diseases or other conditions and circumstances that, according to the investigator's assessment, make it difficult to ensure compliance with study treatment.
• Participation in another clinical trial at the time of screening