Case Report: CD19 CAR-T cells derived from recipient of umbilical cord blood transplantation effectively treated relapsed acute lymphoblastic leukemia after UCBT

Recent advances in chimeric antigen receptors have provided an alternative approach for treating relapsed acute lymphocyte leukemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, relapsed patients who had undergone allogeneic umbilical cord blood transplantation (UCBT) have no chance of having CAR-T cells derived from donors due to lacking UCB. We present a case of a patient with Ph+ ALL who relapsed after UCBT and achieved complete morphological and molecular remission following treatment with CD19 CAR-T cells derived from the recipient post-UCBT. The patient had only grade I CRS. GVHD or neurotoxicity was not observed. More than 6 years after CAR-T cell infusion, the patient was still in hematologic and molecular complete remission with negative minimal residual disease (MRD). This case is the first to show a new strategy of practicality, efficacy, and safety of CD19 CAR-T cells derived from UCBT recipients for treating relapsed ALL after UCBT.