Study on the prognostic value of aberrant antigen in patients with acute B lymphocytic leukemia

Abstract Approximately 30-60% of acute B-lymphocytic leukemia(B-ALL) patients show refractory or relapse,which is one of the major causes of death in B-ALL patients,the methods on the treatment of relapsed / refractory B-ALL (R/R B-ALL) is limited.The chimeric antigen receptors redirected T cells (CAR-T cells) has showed strong anti-leukemia role for B-ALL.About 90% of patients with R/R B-ALL treated with CD19-CART cells achieved complete remission(CR). However, 60-70% of patients relapsed after CAR-T cells treatment,which may be related to target antigen reduction or escape.New products are urgently needed to prevent and treat antigenic escapes causing recurrence.In this paper we retrospectively analyzed the immunophenotype of B-ALL patients initially diagnosed in our center from January 2010 to December 2015 to determine whether aberrant antigen expression was associated with prognosis of patients in order to find new targets for immunotherapy.The result show that disease-free survival(DFS) and overall survival(OS) in patients without aberrant antigen expression were better than patients with aberrant antigen expression.The most common abnormal antigens were CD123,CD13 and CD56.Correlation analysis showed a negative correlation between aberrant CD123 expression and both DFS and OS.Therefore, in the construction of CAR-T cells in patients with R/R B-ALL, conventional CD19 can be combined with aberrant antigens such as CD123 to form CARs with bi-specific antigens or multi-specific antigens may achieve the purpose of improving efficacy. However, more clinical trials are needed.