Figure 1
Figure 1. B-lineage cells, including B-cell precursors, were eradicated from the bone marrow after treatment with anti–CD19-CAR-transduced T cells. (A) Representative pretreatment computed tomography scan images and images from 18 weeks after treatment demonstrate regression of lymphoma masses in the chest and abdomen after treatment with chemotherapy followed by anti–CD19-CAR-transduced T cells plus IL-2. (B) Flow cytometric evaluation of a pretreatment bone marrow aspirate was conducted with a forward versus side light scatter analysis gate of lymphoid cells. The left upper quadrant contains CD19+ B-lineage cells (35% of lymphoid cells), and the right lower quadrant contains CD3+ T cells. (C) Flow cytometric evaluation of a pretreatment bone marrow aspirate with a CD19+ analysis gate is shown. κ- and λ-negative, CD19+, mostly immature B-lineage cells that are not part of the malignant lymphoma clone are in the rectangle. The cells outside the rectangle are mostly lymphoma cells. (D) Flow cytometric evaluation of a pretreatment bone marrow aspirate with a forward versus side light scatter analysis gate of lymphoid cells. Immature B-cell precursors in the oval are CD22+ and CD20−. (E) Flow cytometric evaluation of a pretreatment bone marrow aspirate with a forward versus side light scatter analysis gate of lymphoid cells. Immature B-cell precursors in the polyhedral demonstrate decreasing CD10 correlating with increasing CD20 expression. (F) Flow cytometric evaluation of a bone marrow aspirate from 36 weeks after treatment with a forward versus side light scatter analysis gate of lymphoid cells. CD19+ B-lineage cells are absent. (G) Immunohistochemistry staining of a pretreatment bone marrow biopsy reveals a large population of CD19+ cells that includes lymphoma cells as well as nonmalignant B-lineage cells. (H) Immunohistochemistry staining of a bone marrow biopsy from 36 weeks after infusion of anti–CD19-CAR-transduced T cells demonstrates a complete absence of CD19+ cells. (I) High-power view of the same anti-CD19 staining shown in panel H.

B-lineage cells, including B-cell precursors, were eradicated from the bone marrow after treatment with anti–CD19-CAR-transduced T cells. (A) Representative pretreatment computed tomography scan images and images from 18 weeks after treatment demonstrate regression of lymphoma masses in the chest and abdomen after treatment with chemotherapy followed by anti–CD19-CAR-transduced T cells plus IL-2. (B) Flow cytometric evaluation of a pretreatment bone marrow aspirate was conducted with a forward versus side light scatter analysis gate of lymphoid cells. The left upper quadrant contains CD19+ B-lineage cells (35% of lymphoid cells), and the right lower quadrant contains CD3+ T cells. (C) Flow cytometric evaluation of a pretreatment bone marrow aspirate with a CD19+ analysis gate is shown. κ- and λ-negative, CD19+, mostly immature B-lineage cells that are not part of the malignant lymphoma clone are in the rectangle. The cells outside the rectangle are mostly lymphoma cells. (D) Flow cytometric evaluation of a pretreatment bone marrow aspirate with a forward versus side light scatter analysis gate of lymphoid cells. Immature B-cell precursors in the oval are CD22+ and CD20−. (E) Flow cytometric evaluation of a pretreatment bone marrow aspirate with a forward versus side light scatter analysis gate of lymphoid cells. Immature B-cell precursors in the polyhedral demonstrate decreasing CD10 correlating with increasing CD20 expression. (F) Flow cytometric evaluation of a bone marrow aspirate from 36 weeks after treatment with a forward versus side light scatter analysis gate of lymphoid cells. CD19+ B-lineage cells are absent. (G) Immunohistochemistry staining of a pretreatment bone marrow biopsy reveals a large population of CD19+ cells that includes lymphoma cells as well as nonmalignant B-lineage cells. (H) Immunohistochemistry staining of a bone marrow biopsy from 36 weeks after infusion of anti–CD19-CAR-transduced T cells demonstrates a complete absence of CD19+ cells. (I) High-power view of the same anti-CD19 staining shown in panel H.

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