Open AccessChimeric antigen receptor-modified T-cell therapy for bone marrow and skin relapse Philadelphia chromosome-like acute lymphoblastic leukemia
Author(s) -
Maohua Yang,
Bingcheng Liu,
Ying Wang,
Yuntao Liu,
Xiaoyuan Gong,
Bin Gong,
Yingxi Xu,
Yingchang Mi,
Min Wang,
Jianxiang Wang
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000018639
Subject(s) - medicine , bone marrow , chimeric antigen receptor , leukemia , lymphoma , hematopoietic stem cell transplantation , minimal residual disease , oncology , t cell , transplantation , immunology , immune system
Rationale: Chimeric antigen receptor-modified T-cell (CART) therapy has revolutionized the treatment of patients with relapsed or refractory B-cell acute lymphoblastic leukemia (ALL). However, the capacity of CART therapy has not yet been fully elucidated. Patient concerns: An 18-year-old Chinese male patient presented with multiple firm masses on the skin all over his body following regular chemotherapy. Diagnoses: Bone marrow smear and skin biopsy confirmed that it was a bone marrow and skin relapse from the initial B-cell ALL. Interventions: CD19 CART-cell therapy was performed to manage the bone marrow and skin of the relapsed B-cell ALL. Outcomes: During CART-cell therapy, cytokine release syndrome and central nervous encephalopathy occurred. Eventually, the lesions disappeared, and the bone marrow and skin tested minimal residual disease (MRD) negative. The patient achieved complete remission (CR). Fourteen days after testing MRD negative, he received allogeneic hematopoietic stem-cell transplantation and has remained disease free to date. Lessons: The CR of this patient with leukemia cutis demonstrated that CART exhibited efficacy in this case. While further research is still required, this treatment could potentially be used as a therapy for skin leukemia, lymphoma, and other primary skin cancers.