Sequential CAR T-Cell Therapy After Autologous Stem Cell Transplantation for the Treatment of Relapsed/Refractory Intravascular Large B-Cell Lymphoma With Central Nervous System Involvement: A Case Report

Wanying Liu; Chunrui Li; Yang Cao; Na Wang; Liang Huang; Zhen Shang; Jue Wang; Lifang Huang; Jinhuan Xu; Min Xiao; Yicheng Zhang; Jianfeng Zhou; Liting Chen; Yi Xiao

doi:10.3389/fonc.2022.817969

Sequential CAR T-Cell Therapy After Autologous Stem Cell Transplantation for the Treatment of Relapsed/Refractory Intravascular Large B-Cell Lymphoma With Central Nervous System Involvement: A Case Report

Front Oncol. 2022 Apr 28:12:817969. doi: 10.3389/fonc.2022.817969. eCollection 2022.

Authors

Wanying Liu^{1

2}, Chunrui Li^{1

2}, Yang Cao^{1

2}, Na Wang^{1

2}, Liang Huang^{1

2}, Zhen Shang^{1

2}, Jue Wang^{1

2}, Lifang Huang^{1

2}, Jinhuan Xu^{1

2}, Min Xiao^{1

2}, Yicheng Zhang^{1

2}, Jianfeng Zhou^{1

2}, Liting Chen^{1

2}, Yi Xiao^{1

2}

Affiliations

¹ Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, Hubei, China.
² Immunotherapy Research Center for Hematologic Diseases of Hubei Province Wuhan, Hubei, China.

Abstract

Background: Intravascular large B-cell lymphoma (IVLBCL) is a rare, aggressive, large B-cell non-Hodgkin's lymphoma. The prognosis of IVLBCL in patients with central nervous system recurrence after first-line chemotherapy treatment is extremely poor. Among immunotherapies, chimeric antigen receptor (CAR) T-cell immunotherapy has been recently found to be a highly effective treatment for B-cell lymphoma, especially for relapsed or refractory diffuse large B-cell lymphoma. However, no guidelines are available that provide a clear consensus regarding the management of patients with relapsed/refractory IVLBCL. Here, we report, for the first time, the use of autologous hematopoietic stem cell transplantation (ASCT) and CAR T-cell therapy in a patient with relapsed/refractory IVLBCL.

Case presentation: A 42-year-old woman was diagnosed with IVLBCL based on liver biopsy and developed central nervous system (CNS) progression. The patient received ASCT combined with murine monoclonal anti-CD19 and anti-CD22 CAR T-cell therapy. She achieved complete remission for 22 months so far with negative minimal residual disease and continues to be followed up.

Conclusion: ASCT combined with CAR T-cell therapy was the best choice for treatment of relapsed/refractory IVLBCL, as it allowed the achievement of a lasting complete remission.

Keywords: B-cell lymphoma; CAR T-cell therapy; CNS involvement; IVLBCL; intravascular.

Publication types

Case Reports