CD19-Directed CAR T Cells Treatment in a Patient with Refractory DLBCL and CNS Involvement
# Introduction Diffuse large B-cell lymphoma (DLBCL) is the most common neoplasm of the lymphatic system. Treatment and clinical management are difficult in the relapsed/refractory (R/R) setting. Chimeric antigen receptor (CAR) T cells are genetically engineered using autologous patient lymphocytes...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
THE HEALTHBOOK COMPANY LTD.
2019-09-01
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| Series: | healthbook TIMES. Oncology Hematology |
| Online Access: | https://doi.org/10.36000/hbT.OH.2019.01.005 |
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| Summary: | # Introduction
Diffuse large B-cell lymphoma (DLBCL) is the most common neoplasm of the lymphatic system. Treatment and clinical management are difficult in the relapsed/refractory (R/R) setting. Chimeric antigen receptor (CAR) T cells are genetically engineered using autologous patient lymphocytes and have shown very promising results in the treatment of relapsed and refractory cases of DLBCL.
# Methods
A 64-year-old male patient with refractory DLBCL and central nervous system (CNS) involvement after 9 lines of therapy was treated with CD19-specific CAR T cell therapy at the Department of medical oncology and hematology at the University Hospital of Zurich and followed-up for 10 weeks.
# Results
Autologous lymphocytes were successfully harvested and transfected/expanded for CAR T cell production. Conditioning chemotherapy and CAR T infusion was well tolerated. Post-infusion side effects were mild (cytokine release syndrome \[CRS\] grade 1–2), with limited signs of neurotoxicity. Ten weeks after CAR T cell therapy, an excellent response could be documented via PET-CT. The CNS lesion disappeared as assessed via cranial MRI.
# Conclusion
CD19-targeted CAR T cell therapy is a revolutionary treatment option for heavily pretreated R/R DLBCL even in the setting of CNS involvement. |
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| ISSN: | 2673-2092 2673-2106 |