CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Epcoritamab as bridging therapy to successful second allogeneic HSCT in relapsed DLBCL after UCBT and CAR T cell therapy.
Epcoritamab as bridging therapy to successful second allogeneic HSCT in relapsed DLBCL after UCBT and CAR T cell therapy.
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一名53岁女性在首次获得完全代谢缓解(CMR)16年后,弥漫大B细胞淋巴瘤(DLBCL)复发。尽管最初对挽救化疗无应答,她随后达到第二次CMR并接受脐带血移植(UCBT)。移植后第119天再次复发,患者接受CAR-T 细胞治疗并获得第三次缓解,未发生细胞因子释放综合征或移植物抗宿主病(GVHD)。然而,CAR-T 治疗7个月后疾病第三次复发。开始使用epcoritamab治疗后,患者再次达到CMR,且无严重并发症。随后,患者接受具有治愈目的的非亲缘供者异基因外周血造血干细胞移植(HSCT)。未发生严重移植相关并发症,包括重度GVHD或感染。第二次移植后,患者持续CMR超过1年。Epcoritamab似乎是治疗DLBCL复发的有效且安全选择,即使患者既往接受过UCBT和CAR-T 治疗也如此。这提示,先以epcoritamab桥接治疗,再进行第二次异基因HSCT,可能实现长期生存。
A 53-year-old woman experienced relapse of diffuse large B cell lymphoma (DLBCL) 16 years after achieving a first complete metabolic response (CMR). Despite initially being refractory to salvage chemotherapy, she achieved a second CMR and underwent umbilical cord blood transplantation (UCBT). On day 119 post-transplantation, she experienced a second relapse and received chimeric antigen receptor T (CAR T) cell therapy, achieving a third remission without cytokine release syndrome or graft-versus-host disease (GVHD).
However, a third relapse occurred seven months after CAR T cell therapy. Epcoritamab treatment was initiated, resulting in CMR without severe complications. Subsequently, the patient underwent curative unrelated allogeneic peripheral blood hematopoietic stem cell transplantation (HSCT). She experienced no severe transplant-related complications, including serious GVHD or infections.
She has remained in CMR for > 1 year after the second transplant. Epcoritamab appears to be an effective and safe treatment option for DLBCL relapse, even after both UCBT and CAR T cell therapy, suggesting that bridging therapy with epcoritamab followed by a second allogeneic HSCT may achieve long-term survival.
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