决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Case Report: CD19 and CD22 CAR-T therapy induced durable complete remission in a patient with refractory plasmablastic lymphoma.
一名难治性PBL患者在接受CD19和CD22 CAR-T治疗后获得持久完全缓解,提示该治疗可能对难治性或复发性PBL患者有效。
浆母细胞淋巴瘤(PBL)是一种罕见且高度侵袭性的非霍奇金淋巴瘤,预后较差。传统化疗对PBL的疗效有限。目前对于难治性或复发性PBL患者尚无标准治疗方案。虽然CAR-T疗法在白血病、淋巴瘤和骨髓瘤中显示出良好的前景,但其在PBL中的应用证据仍然很少。病例介绍:我们描述了一名诊断为PBL的56岁患者。该患者接受硼替佐米联合依托泊苷、地塞米松、环磷酰胺和多柔比星作为一线治疗,获得了短期缓解。疾病进展后,患者接受达雷妥尤单抗联合GemOx作为二线治疗,但未见反应。疾病进展后的肿瘤活检显示CD22强阳性,CD19部分阳性。患者接受CD19和CD22 CAR-T疗法作为三线治疗,获得了持续一年以上的持久完全缓解,且耐受性良好。
INTRODUCTION: Plasmablastic lymphoma (PBL) is a rare and highly aggressive form of non-Hodgkin lymphoma that is associated with a poor prognosis. Traditional chemotherapy has demonstrated limited efficacy for PBL. There is currently no standard treatment for patients with refractory or relapsing PBL. While CAR-T therapy has shown promising outcomes in leukemia, lymphoma and myeloma, evidence of its application in PBL remains scarce. CASE PRESENTATION: We describe a 56-year-old patient diagnosed with PBL. The patient achieved short-term remission with bortezomib in combination with etoposide, dexamethasone, cyclophosphamide, and doxorubicin as first-line therapy. After disease progression, the patient received daratumumab combined with GemOx as second-line treatment but showed no response. Tumor biopsy after disease progression revealed strong positive CD22 and partial positive CD19 expression. The patient received CD19 and CD22 CAR-T therapies as the third-line treatment and achieved durable complete remission for more than one year with good tolerance. CONCLUSION: A patient with refractory PBL achieved durable complete remission after CD19 and CD22 CAR-T therapies, suggesting this treatment may be effective for patients with refractory or relapsing PBL.
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