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CASE REPORT article
Front. Oncol.
Sec. Hematologic Malignancies
Volume 14 - 2024 |
doi: 10.3389/fonc.2024.1491100
This article is part of the Research Topic Host Features Affecting CAR T Cell Therapy of Hematological Malignancies View all articles
Case Report: CAR-T therapy demonstrated safety and efficacy in relapsed/refractory diffuse large B-cell lymphoma patients complicated with hepatitis B related cirrhosis
Provisionally accepted- The First Affiliated Hospital of Soochow University, Suzhou, China
Chimeric antigen receptor T-cell (CAR-T) therapy has demonstrated both efficacy and safety in relapsed/refractory diffuse large B-cell lymphoma (DLBCL) patients infected with hepatitis B virus (HBV). However, its applicability in individuals with liver cirrhosis remains largely unexplored due to the potential for unpredictable complications. Here, we report three cases (P1, P2, P3) of relapsed/refractory DLBCL with HBV-related cirrhosis treated with CAR-T cells infusion. P1 and P2 received CAR-T cells infusion following a conditioning regimen of fludarabine and cyclophosphamide (FC) for lymphodepletion; while P3 received SEAM (semustine, etoposide, cytarabine, and melphalan) regimen and autologous stem cell transplantation bridging CAR-T cells infusion. P1 and P2 achieved rapid complete remission (CR), whereas P3 initially exhibited stable disease a month post-CAR-T infusion and subsequently achieved CR after local radiation salvage therapy and lenalidomide maintenance. With a median follow-up of 42 months after CAR-T, the progression free survival rate was 100%. Notably, during follow-up, these patients experienced complications associated with cirrhosis, including endoscopic variceal bleeding, HBV reactivation, or the diagnosis of hepatic malignancy. Our findings suggest that CAR-T therapy is applicable and effective for the treatment of DLBCL patients with HBV-related cirrhosis, albeit necessitating monitoring for potential hepatic complications.
Keywords: Diffuse large B-cell lymphoma, cirrhosis, Chimeric antigen receptor T-cell therapy, Hepatitis B virus, case report
Received: 04 Sep 2024; Accepted: 11 Nov 2024.
Copyright: © 2024 Kong, Ping, Zhu, Zhang, Li, Zou, Wu, Jin and Qu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Nana Ping, The First Affiliated Hospital of Soochow University, Suzhou, China
Qian Zhu, The First Affiliated Hospital of Soochow University, Suzhou, China
Xiao Zhang, The First Affiliated Hospital of Soochow University, Suzhou, China
Junhong Li, The First Affiliated Hospital of Soochow University, Suzhou, China
Rui Zou, The First Affiliated Hospital of Soochow University, Suzhou, China
Depei Wu, The First Affiliated Hospital of Soochow University, Suzhou, China
Zhengming Jin, The First Affiliated Hospital of Soochow University, Suzhou, China
Changju Qu, The First Affiliated Hospital of Soochow University, Suzhou, China
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