Cord Blood-derived CD70-targeting CAR-NK Cell Therapy for Refractory/Relapsed T Cell Lymphoma and Acute Myeloid Leukemia
CD70 is a promising target for immunotherapy because it is overexpressed in T-cell lymphoma (TCL) and acute myeloid leukemia (AML) tumor cells but is found in deficient levels in normal tissues and hematopoietic stem cells. This study aims to evaluate the safety and efficacy of CD70-targeted CAR-NK (CD70-CAR-NK) cells in patients with relapsed and refractory TCL and AML.
∙ According to the WHO disease classification, patients with relapsed/refractory T - lymphoma and acute myeloid leukemia:
• Voluntarily participate in this study and sign the informed consent form;
• Aged between 18-75 years old, both male and female are eligible;
• Relapsed/refractory T cell lymphoma is defined as: relapsed/refractory after having received at least two or more lines of previous treatment (patients with anaplastic large -cell lymphoma must have been exposed and resistant to Brentuximab vedotin). The celluar subtypes of T-cell lymphoma include: angioimmunoblastic T-cell lymphoma; peripheral T - cell lymphoma not otherwise specified; ALK-negative anaplastic large - cell lymphoma; Relapsed/refractory AML is defined as: leukemia cells reappear in the peripheral blood after complete remission or the blasts in the bone marrow ≥ 5% or the extramedullary leukemia infiltration outside. Or newly diagnosed cases did not achieve a CR after two courses of standard regimens; those who relapse within 12 months after CR after consolidation and intensification treatment; those who relapse after 12 months and have not responded to conventional chemotherapy; those who relapse two or more times; those with persistent extramedullary leukemia;
• The expected survival period ≥ 12 weeks;
• CD70 expression is positive in tumor tissue puncture sections/tumor cells detected by flow cytometry, and the number of CD70 - positive cells detected by immunohistochemistry ≥ 20% (++ or more);
• ECOG score is 0 - 2;
• Adequate organ function reserve:
‣ Alanine aminotransferase and aspartate aminotransferase ≤ 2.5× UNL;
⁃ Creatinine clearance rate (Cockcroft - Gault method) ≥ 60 mL/min;
⁃ Serum total bilirubin and alkaline phosphatase ≤ 1.5× UNL;
⁃ Glomerular filtration rate \> 50 ml/min;
⁃ Cardiac ejection fraction ≥ 45%;
⁃ Under indoor natural air environment, the basic oxygen saturation \> 92%;
⁃ Routine blood test: absolute neutrophil count \> 1000/mm3, platelet count ≥ 45×109, hemoglobin ≥ 8.0g/dl (the standard for AML patients is ≥ 7.0g/dl; blood transfusion is allowed);
• Previous autologous hematopoietic stem cell transplantation is allowed once;
• Patients who have previously received CAR - T cell therapy and were evaluated as ineffective after 3 months or relapsed after CR are allowed;
⁃ Female subjects of childbearing age must have a negative pregnancy test and agree to take effective contraceptive measures during the trial period;
⁃ No active lung infection, and indoor air blood oxygen saturation ≥ 92%;
⁃ Before the study drug is used, approved anti - tumor treatment methods, such as systemic chemotherapy, whole - body radiotherapy, and immunotherapy, have been completed for at least 3 weeks; the wash - out period for targeted drug regimens without chemotherapy is 2 weeks;
⁃ Two negative tests for COVID - 19 or influenza A.