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异基因 CAR-T 桥接 allo-HSCT 作为难治性成人伯基特淋巴瘤治疗策略:一例病例报告

英文原题:Allogeneic CAR-T bridging to allo-HSCT as a treatment strategy for refractory adult Burkitt's lymphoma: a case report.

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Allogeneic CAR-T bridging to allo-HSCT as a treatment strategy for refractory adult Burkitt's lymphoma: a case report.

PubMed 2022/08/01(内容时间) Transl Cancer Res Q3 · IF 2.1(JCR 2025)

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研究概要

目前的结果已证实,异体 CAR-T 细胞可为更多患者提供更好的治疗机会。据我们所知,这是首例异体 CAR-T 细胞治疗桥接 allo-HSCT 用于治疗原发性宫颈 BL 的报道。它为难治性成人 BL 提供了更多治疗选择。

研究思路结论见上方概要

EBV阴性Burkitt淋巴瘤(BL)具有高度侵袭性,诊断时病变局限于子宫颈极为罕见。原发性宫颈BL由于罕见而缺乏标准化的管理方案。自体CAR-T(CAR-T)细胞治疗在B细胞恶性肿瘤中取得了良好疗效,但对BL的效果并不理想。随着新技术的不断发展,异体CAR-T 细胞治疗不断优化,变得更加安全有效,可能成为预后差、治疗手段不足的恶性肿瘤病例的一线治疗选择。病例描述:一名中年中国女性患者因不明原因阴道出血和宫颈肿块入院,经病理检查诊断为原发性宫颈BL。在多线化疗失败后,患者接受了供者来源的CD19/CD22双靶点CAR-T 细胞治疗,在桥接异基因造血干细胞移植(allo-HSCT)前达到部分缓解。遗憾的是,我们的患者最终在中性粒细胞和血小板植入前死于allo-HSCT相关并发症和感染性休克。

展开英文摘要原文

Epstein-Barr-virus-negative Burkitt's lymphoma (BL) is highly aggressive, and it is extremely rare that the lesion is confined to the uterine cervix at the time of diagnosis. Primary BL of the cervix lacks standardization of management due to its rarity. Autologous chimeric-antigen-receptor-T (CAR-T) cell therapy has achieved favourable outcomes in B cell malignant tumors, but the effect on BL is not satisfactory. With the continuous development of new technologies, allogeneic CAR-T cell therapy is constantly optimized, becoming safer and more effective, and it may become the first-line treatment option for malignant tumor cases with poor prognosis and insufficient treatment approaches. CASE DESCRIPTION: A middle-aged Chinese female patient was admitted to the hospital for unexplained vaginal bleeding and cervical mass, and was diagnosed as primary BL of the cervix through pathological examination. After the failure of multi-line chemotherapy, the patient received donor-derived CD19/CD22 dual-targeted CAR-T cell therapy and achieved partial remission before bridging to allogeneic hematopoietic stem cell transplantation (allo-HSCT). Unfortunately, our patient eventually died of complications associated with allo-HSCT and septic shock before neutrophil and platelet implantation.

The current results have confirmed that allogeneic CAR-T cells could provide better treatment opportunities for more patients. To our knowledge, this is the first report of allogeneic CAR-T cell therapy bridging to allo-HSCT in the treatment of primary BL of the cervix. And it provides a more treatment options for refractory adult BL.

论文信息

作者
Cheng L、Huang M、Cao Y、Wang J、Xu H、Jiang L
第一作者单位
Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.China
通讯作者单位
Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.China
文献类型
病例报告
期刊
Translational cancer research2022 Aug
原文标识
PubMed 36093513 · DOI 10.21037/tcr-22-174