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CAR-T 细胞治疗后 EBV 相关淋巴增殖性疾病

英文原题:EBV-associated lymphoproliferative disease post-CAR-T cell therapy.

查看英文原题

EBV-associated lymphoproliferative disease post-CAR-T cell therapy.

PubMed 2024/02/08(内容时间) Front Med

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中文摘要

EBV相关淋巴增殖性疾病(EBV-LPDs)是实体器官移植或异基因造血干细胞移植(HSCT)后常见的并发症。然而,其在嵌合抗原受体修饰T(CAR-T)细胞治疗后的发生和治疗尚未见报道。两名患者被诊断为EBV阳性侵袭性B细胞淋巴瘤,并在多线治疗后出现复发。在接受CAR-T 细胞治疗联合自体HSCT后,患者获得完全缓解。然而,在CAR-T 细胞治疗后中位时间38.5个月时,被诊断为B细胞来源的EBV-LPDs,并通过给予免疫检查点抑制剂或B细胞清除剂获得缓解。总之,我们的报告提示EBV-LPDs可能是CAR-T 细胞治疗后的长期不良事件,尤其是在既往有EBV阳性疾病的患者中,并且可通过免疫正常化策略或B细胞清除治疗得到解决。

展开英文摘要原文

Epstein-Barr virus (EBV)-associated lymphoproliferative diseases (EBV-LPDs) are common complications that occur after solid organ transplantation or allogeneic hematopoietic stem-cell transplantation (HSCT).

However, their occurrence and treatment post-chimeric antigen receptor-modified T (CAR-T) cell therapy has not been reported. Two patients had been diagnosed with EBV-positive aggressive B-cell lymphoma and experienced relapses after multiple lines of treatment. After receiving CAR-T cell therapy in tandem with autologous HSCT, the patients achieved complete remission.

However, with a median time of 38. 5 months after CAR-T cell therapy, B-cell-derived EBV-LPDs were diagnosed, and they were relieved through the administration of immune checkpoint inhibitor or B-cell-depleting agents. Collectively, our report suggests that EBV-LPDs may represent a long-term adverse event after CAR-T cell therapy, especially in patients who previously had EBV-positive disorders, and they can be resolved by immune normalization strategy or B-cell depleting therapy.

论文信息

作者
Zhang S、Zhou X、Zhang S、Wang N、Zhang T、Zhang D、Ao Q、Cao Y
第一作者单位
Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.China
通讯作者单位
Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. lhuang@tjh.tjmu.edu.cn.China
文献类型
病例报告
期刊
Frontiers of medicine2024 Apr
原文标识
PubMed 38329597 · DOI 10.1007/s11684-023-1032-8