Fig. 1

Efficacy of chemotherapy and CART19 therapy in the patient (female, 43 years old). a Trend in BCR-ABL/ABL ratio after chemotherapy combined with tyrosine kinase inhibitor (TKI) treatment and CART therapy. The patient underwent courses of VDCLP (vincristine, daunomycin, cyclophosphamide, asparaginase, and dexamethasone), hyper-CVAD part A (cyclophosphamide, vincristine, doxorubicin, and dexamethasone), hyper-CVAD part B (methotrexate and cytosine arabinoside), IAE (idarubicin, cytosine arabinoside, and etoposide), MTX (methotrexate) + l-ASP (l-asparaginase), IA (idarubicin and cytosine arabinoside), and EA (etoposide and cytosine arabinoside) + DXM (dexamethasone) chemotherapy. Three times of the central nervous system lymphoma (CNSL) were also indicated. About 15 times of intrathecal chemotherapy with methotrexate, cytosine arabinoside, and DXM without cranial irradiation were performed before CART19 infusion. Her cerebral spinal fluid (CSF) contained no white blood cells (WBCs) and normal level of protein when she was recruited for the CART19 clinical trial. Before CART19 infusion, 10.7 % cells remaining in the marrow were CD19+ leukemia cells, and BCR-ABL/ABL ratio in the marrow was 27 %. b Lentiviral vector applied to transfect T lymphocytes from the patient. A pseudotyped clinical-grade lentiviral vector including anti-CD19 scFv derived from FMC63 murine monoclonal antibody, human CD8α hinge, and transmembrane domain and human 4-1BB and CD3ζ-signaling domains was constructed. c Procedure of CART19 manufacture and the clinical application scheme. Lymphocyte-depleting chemotherapy regimen FC consisted of FLU (fludarabine) 30 mg/m² days 1 to 3 and CTX (cyclophosphamide) 750 mg/m² day 3