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复发性间变性少突胶质细胞瘤经 WT-1 特异性 CD8+ T 细胞治疗获得长期缓解:一例病例报告

英文原题:Long-Term Remission of Recurrent Anaplastic Oligodendroglioma With WT-1-Specific CD8+ T-Cell Therapy: A Case Report.

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Long-Term Remission of Recurrent Anaplastic Oligodendroglioma With WT-1-Specific CD8+ T-Cell Therapy: A Case Report.

PubMed 2025/04/01(内容时间) Brain Tumor Res Treat

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中文摘要

我们报告一例间变性少突胶质细胞瘤在接受自体Wilms瘤1(WT-1)特异性CD8+ T细胞过继细胞治疗(ACT)后获得完全缓解的病例。一名40岁女性因复发性间变性少突胶质细胞瘤转诊至我院接受辅助化疗,最初表现为左额叶肿瘤,以癫痫发作为首发症状,次全切除术后确诊为少突胶质细胞瘤(WHO 2级)。放疗治疗残余肿瘤,获得部分缓解,直至2.5年后复发,第二次开颅术后发生恶性转化为间变性少突胶质细胞瘤(WHO 3级)。经过三个周期的丙卡巴肼、洛莫司汀和长春新碱化疗后,残余肿瘤稳定3年。

然而,随访MRI发现一个新的强化病灶,促使进行第三次开颅术。确诊为复发性间变性少突胶质细胞瘤,并开始辅助质子束治疗和替莫唑胺化疗。两年后,相邻的内侧额叶又出现另一个强化病灶。经过多学科讨论,我们引入了WT-1特异性ACT。尽管治疗后1个月观察到短暂肿胀,但肿瘤在3-9个月内表现出缓解。持续消退导致完全缓解——在15个月随访时经MRI确认,并持续4.7年。患者的外周血单核细胞谱和免疫相关细胞因子分析表明WT-1致敏后出现T细胞活化。

展开英文摘要原文

We report a case of complete remission in anaplastic oligodendroglioma following adoptive cell therapy (ACT) with autologous Wilms tumor 1 (WT-1)-specific CD8+ T cells. A 40-year-old woman referred to our hospital for adjuvant chemotherapy after recurrent anaplastic oligodendroglioma initially presented with a left frontal tumor, diagnosed through seizure onset, and subtotal resection confirmed oligodendroglioma (WHO grade 2).

Radiation therapy treated the residual tumor, achieving partial remission until recurrence 2. 5 years later when malignant transformation to anaplastic oligodendroglioma (WHO grade 3) occurred following a second craniotomy. After three cycles of procarbazine, lomustine, and vincristine chemotherapy, the residual tumor stabilized for 3 years.

However, follow-up MRI identified a new enhancing lesion, prompting a third craniotomy. Recurrent anaplastic oligodendroglioma was confirmed, and adjuvant proton beam therapy and temozolomide chemotherapy were initiated. Two years later, another enhancing lesion appeared on the adjacent medial frontal lobe. Following multidisciplinary review, we introduced WT-1-specific ACT.

Although transient swelling was observed 1 month post-therapy, the tumor demonstrated a response within 3-9 months. Continued regression led to complete remission-confirmed via MRI at the 15-month follow-up and sustained for 4. 7 years. The patient's peripheral blood monocyte profiles and immune-associated cytokine analysis indicated T-cell activation following WT-1 sensitization.

论文信息

作者
Gwak HS、Choi BK、Lee YJ、Han NY、Yang KH
单位
Department of Cancer Biomedical Science, National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, Korea. nsghs@ncc.re.kr.South Korea
文献类型
病例报告
期刊
Brain tumor research and treatment2025 Apr
原文标识
PubMed 40347129 · DOI 10.14791/btrt.2025.0010