Chimeric antigen receptor T-cell therapy following autologous transplantation for secondary central nervous system lymphoma: A case report. Issue 44 (5th November 2021)

• Record Type: Journal Article
• Authors: Yagi, Yu; Kanemasa, Yusuke; Ohigashi, An; Morita, Yuka; Tamura, Taichi; Nakamura, Shohei; Otsuka, Yuki; Kishida, Yuya; Kageyama, Akihiko; Shimizuguchi, Takuya; Toya, Takashi; Shimizu, Hiroaki; Najima, Yuho; Kobayashi, Takeshi; Haraguchi, Kyoko; Doki, Noriko; Okuyama, Yoshiki; Omuro, Yasushi; Shimoyama, Tatsu
• Other Names: Saranathan. Maya section editor.
• Is Part Of: Medicine. Volume 100:Issue 44(2021)
• Publication Date: 2021-11-05
• Subjects: autologous stem cell transplantation -- case report -- central nervous system relapse -- chimeric antigen receptor T-cell therapy -- intravascular large B-cell lymphoma; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000027733
• Languages: English
• ISSNs: 0025-7974

Abstract

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.