Open AccessChimeric antigen receptor T-cell therapy following autologous transplantation for secondary central nervous system lymphoma
Author(s) -
Yan Yu,
Yusuke Kanemasa,
An Ohigashi,
Yuka Morita,
Taichi Tamura,
Shohei Nakamura,
Yuki Otsuka,
Yuya Kishida,
Akihiko Kageyama,
Takuya Shimizuguchi,
Takashi Toya,
Hiroaki Shimizu,
Yuho Najima,
Takeshi Kobayashi,
Kazutoshi Haraguchi,
Noriko Doki,
Yoshiki Okuyama,
Yasushi Omuro,
Tatsu Shimoyama
Publication year - 2021
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.0000000000027733
Subject(s) - medicine , chimeric antigen receptor , cytokine release syndrome , lymphoma , transplantation , autologous stem cell transplantation , cell therapy , oncology , immunology , t cell , stem cell , immune system , biology , genetics
Abstract Rationale: Chimeric antigen receptor (CAR) T-cell therapy is effective in treating relapsed and refractory B-cell non-Hodgkin lymphoma. However, because of the mortality risk associated with immune effector cell-associated neurotoxicity syndrome and pseudoprogression, patients with central nervous system (CNS) involvement are less likely to receive CAR T-cell therapy. Patients concerns: We report a case of a 61-year-old, male patient with intravascular large B-cell lymphoma who suffered a CNS relapse after standard chemotherapy. Diagnosis: A diagnosis of intravascular large B-cell lymphoma with CNS involvement was made. Interventions: We treated the patient using CAR T-cell therapy following a conditioning regimen consisting of thiotepa and busulfan and autologous stem cell transplantation. Although he experienced grade 1 cytokine release syndrome, no other serious adverse events, such as immune effector cell-associated neurotoxicity syndrome or pseudoprogression, were observed. Outcomes: The patient achieved complete remission after the CAR T-cell infusion. Lessons: CAR T-cell therapy following autologous stem cell transplantation is a viable option for relapsed/refractory lymphoma with CNS infiltration. Further clinical studies are warranted to verify its safety and efficacy.