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病例报告:CD20 双特异性抗体治疗后 CD19 CAR-T 细胞治疗后记忆形成的旁观者 T 细胞反应受损

英文原题:Case Report: Compromised response of memory-formed bystander T cells after CD19 CAR-T cell therapy following CD20 bispecific antibody therapy.

PubMed 2026/04/22(内容时间) Front Immunol Q1 · IF 7(JCR 2025)

研究概要

尽管暂停 BsAb 治疗后记忆 T 细胞表型在 8 周内保持不变,但发现旁观者中央/效应记忆 T 细胞在序贯 CAR-T 细胞治疗后于外周血中新生并成功产生。

中文摘要

采用嵌合抗原受体(CAR)T 细胞和/或双特异性抗体(BsAb)重定向 T 细胞,已成为复发/难治性大 B 细胞淋巴瘤的新治疗选择。体内旁观者 T 细胞可能影响治疗后的免疫应答,但其记忆 T 细胞特征和抗原特异性应答仍未明确。本文聚焦记忆形成的旁观者 T 细胞,并考察一名复发/难治性弥漫性大 B 细胞淋巴瘤患者的病毒特异性反应;该患者先接受 CD20 BsAb 治疗,随后接受 CD19 CAR-T 治疗,并发生罕见并发症腺病毒性出血性膀胱炎。BsAb 治疗后,患者外周血以效应记忆 T 细胞为主,并获得完全缓解,且未发生非预期病毒感染。暂停 BsAb 治疗后 8 周内,记忆 T 细胞表型保持不变;序贯 CAR-T 治疗后,外周血中则新出现并成功形成旁观者中央/效应记忆 T 细胞。值得注意的是,治疗期间患者未发生常见病毒感染(如巨细胞病毒再激活);但在 CAR-T 治疗后,即使外周存在记忆 T 细胞,仍发生腺病毒性膀胱炎,而 BsAb 治疗期间没有发生。结果似乎提示 BsAb 治疗期间与 CAR-T 治疗后记忆 T 细胞应答存在差异,也促使我们重新审视 CAR-T 治疗后形成记忆的旁观者 T 细胞及其新生抗原特异性 T 细胞应答。

展开英文摘要原文

T-cell redirection using chimeric antigen receptor (CAR)-T cells and/or bispecific antibody (BsAb) has been recognized as a new therapeutic option for relapsed/refractory large B-cell lymphoma. Bystander T cells in the body can affect immune responses after the treatment; however, their memory T-cell characteristics and antigen-specific responses still remain undefined. Here, we focused on memory-formed bystander T cells, and considered their viral-specific responses in a relapsed/refractory diffuse large B-cell lymphoma patient who developed adenoviral hemorrhagic cystitis as an uncommon complication after CD19 CAR-T cell therapy following CD20 BsAb therapy. After BsAb therapy, effector memory T cells were the predominant population in the patient's peripheral blood, achieving a complete response without unwanted viral infection. Although memory T-cell phenotypes remained unchanged for 8 weeks after pausing of BsAb therapy, it was found that bystander central/effector memory T cells had newly and successfully developed in the peripheral blood after sequential CAR-T cell therapy. Importantly, this patient did not develop any common viral infections during the course of treatment, such as reactivation of cytomegalovirus; however, adenoviral cystitis occurred even in the presence of memory T cells in the periphery after CAR-T cell therapy but not during BsAb therapy. These findings appear to suggest a difference between memory T-cell responses during BsAb therapy and those following CAR-T cell therapy, providing an important opportunity to reconsider memory-formed but newly-developed bystander T cells and their antigen-specific T-cell responses after CAR-T cell therapy.

论文信息

作者
Masuda Y、Kato J、Konishi T、Honda T、Maruta M、Kawasaki N、Matsumoto M、Oka K
单位
Department of Hematology, Clinical Immunology, and Infectious Diseases, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.Japan
文献类型
病例报告
期刊
Frontiers in immunology2026
原文标识
PubMed 42099636 · DOI 10.3389/fimmu.2026.1756756