دورية أكاديمية
A case of successful CAR-T cell therapy for early isolated CNS recurrence of DLBCL with persistent CAR-T cells.
| العنوان: | A case of successful CAR-T cell therapy for early isolated CNS recurrence of DLBCL with persistent CAR-T cells. |
|---|---|
| المؤلفون: | Takigawa, Ken, Kawano, Noriaki, Mori, Yasuo, Yamauchi, Takuji, Tochigi, Taro, Miyawaki, Kohta, Mori, Kyohei, Shimo, Masatoshi, Nakaike, Takashi, Yamashita, Kiyoshi, Mashiba, Koichi, Kikuchi, Ikuo, Marutsuka, Kousuke, Ohshima, Koichi, Kato, Koji, Akashi, Koichi |
| المصدر: | Blood Cell Ther ; ISSN:2432-7026 ; Volume:7 ; Issue:2 |
| بيانات النشر: | PubMed Central |
| سنة النشر: | 2024 |
| المجموعة: | PubMed Central (PMC) |
| مصطلحات موضوعية: | CAR-T cell therapy, CNS lymphoma, CRS, ICANS, dynamics of CAR-T cells in PB |
| الوصف: | Secondary central nervous system (CNS) lymphomas typically require CNS-penetrating drugs; however, the available agents are limited with temporary effects and poor outcomes. Chimeric antigen receptor T (CAR-T) cell therapy (lisocabtagene maraleucel; liso-cel) has been used to treat a few cases of isolated secondary CNS lymphoma. Herein, we report the case of a 66-year-old male diagnosed with diffuse large B-cell lymphoma (Ann Arbor grade IV; R-IPI, good risk; CNS IPI: Intermediate risk) who achieved complete remission (CR) after six courses of R-CHOP therapy. Three months later, he presented with ptosis and eye movement disorder. Systemic CT and bone marrow examination revealed no lymphoma. Although cranial-enhanced MRI showed normal findings, an increased number of B-cells (51/μL) with the original lymphoma phenotype (CD19+CD79a+CD5-CD10-CD20-Igλ+) was detected in cerebrospinal fluid (CSF), indicating an isolated CNS relapse. Seven high-dose methotrexate courses led to partial response. Subsequently, the patient received CAR-T cell therapy with tolerable adverse events - cytokine release syndrome treated with tocilizumab, no immune effector cell-associated neurotoxicity syndrome, and bone marrow failure treated with granulocyte-colony stimulating factor and eltrombopag. Sequential flow cytometry revealed a high peak of CAR-T cells and the presence of residual CAR-T cells in the peripheral blood, indicating immune surveillance of CNS lymphoma by CAR-T cells. This treatment led to a second CR. This case is the first to validate the efficacy and safety of CAR-T cell therapy for isolated secondary CNS lymphoma in clinical practice. Future accumulation of evidence on the efficacy and safety of CAR-T cell therapy is essential. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | https://doi.org/10.31547/bct-2023-032Test; https://pubmed.ncbi.nlm.nih.gov/38854403Test; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11153208Test/ |
| DOI: | 10.31547/bct-2023-032 |
| الإتاحة: | https://doi.org/10.31547/bct-2023-032Test https://pubmed.ncbi.nlm.nih.gov/38854403Test https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11153208Test/ |
| حقوق: | Copyright Ⓒ2024 Asia-Pacific Blood and Marrow Transplantation Group (APBMT). |
| رقم الانضمام: | edsbas.C9A047AC |
| قاعدة البيانات: | BASE |
| DOI: | 10.31547/bct-2023-032 |
|---|