探索供体来源的 CLL-1 嵌合抗原受体 T 细胞疗法 (CAR-T) 治疗复发/难治性急性髓系白血病 (R/R AML) 桥接同种异体造血干细胞移植 (allo-HSCT) 的疗效和安全性一名成年 R/R AML 患者接受了供体来源的 CLL-1 CAR-T 细胞输注，并在移植后 CAR-T 治疗后第 11 天缓解后立即开始过渡至异基因 HSCT 的预处理方案。然后，常规进行HSCT后血细胞计数、骨髓（BM）形态、流式细胞术、移植物抗宿主病（GVHD）表现和嵌合状态监测。CAR-T治疗后，细胞因子释放综合征为1级CAR-T 治疗后第 11 天，BM 形态达到完全缓解 (CR)，并开始过渡至异基因造血干细胞移植 (allo-HSCT) 的预处理方案。分别在异基因 HSCT 后第 18、23 和 26 天观察到白细胞植入、完全供体嵌合和血小板植入。 BM 形态显示 CR 和流式细胞术在第 23 天转为阴性。该患者目前处于同种异体 HSCT 后 4 个月，BM 形态 CR、流式细胞术阴性、完全供体嵌合，无髓外复发/GVHD。供体源性 CLL -1 CAR-T是治疗R/R AML的一种有效且安全的疗法，缓解后立即桥接至allo-HSCT可能会更好地改善R/R AML的长期预后。版权所有 © 2024 苗帅韩张、刘、姚、王、何、陈、范、常、苏、易。

Explore the efficacy and safety of donor-derived CLL-1 chimeric antigen receptor T-cell therapy (CAR-T) for relapsed/refractory acute myeloid leukemia (R/R AML) bridging to allogeneic hematopoietic stem cell transplantation (allo-HSCT) after remission.An adult R/R AML patient received an infusion of donor-derived CLL-1 CAR-T cells, and the conditioning regimen bridging to allo-HSCT was started immediately after remission on day 11 after CAR-T therapy upon transplantation. Then, routine post-HSCT monitoring of blood counts, bone marrow (BM) morphology, flow cytometry, graft-versus-host disease (GVHD) manifestations, and chimerism status were performed.After CAR-T therapy, cytokine release syndrome was grade 1. On day 11 after CAR-T therapy, the BM morphology reached complete remission (CR), and the conditioning regimen bridging to allo-HSCT started. Leukocyte engraftment, complete donor chimerism, and platelet engraftment were observed on days +18, +23, and +26 post-allo-HSCT, respectively. The BM morphology showed CR and flow cytometry turned negative on day +23. The patient is currently at 4 months post-allo-HSCT with BM morphology CR, negative flow cytometry, complete donor chimerism, and no extramedullary relapse/GVHD.Donor-derived CLL-1 CAR-T is an effective and safe therapy for R/R AML, and immediate bridging to allo-HSCT after remission may better improve the long-term prognosis of R/R AML.Copyright © 2024 Miao, Shuai, Han, Zhang, Liu, Yao, Wang, He, Chen, Fan, Chang, Su and Yi.