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Management of a patient with mantle cell lymphoma who developed severe neurotoxicity after chimeric antigen receptor T-cell therapy in ZUMA-2

Cerebral edema following chimeric antigen receptor (CAR) T-cell therapy can be fatal. ZUMA-2 is a pivotal phase 2, multicenter study evaluating KTE-X19, an autologous anti-CD19 CAR T-cell therapy, in relapsed/refractory mantle cell lymphoma. We describe a 65-year-old patient in ZUMA-2 who developed...

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Autores principales: Wang, Michael, Jain, Preetesh, Chi, T Linda, Chen, Sheree E, Heimberger, Amy, Weathers, Shiao-Pei, Zheng, Lianqing, Rao, Arati V, Rossi, John M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7570235/
https://www.ncbi.nlm.nih.gov/pubmed/33067318
http://dx.doi.org/10.1136/jitc-2020-001114
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author Wang, Michael
Jain, Preetesh
Chi, T Linda
Chen, Sheree E
Heimberger, Amy
Weathers, Shiao-Pei
Zheng, Lianqing
Rao, Arati V
Rossi, John M
author_facet Wang, Michael
Jain, Preetesh
Chi, T Linda
Chen, Sheree E
Heimberger, Amy
Weathers, Shiao-Pei
Zheng, Lianqing
Rao, Arati V
Rossi, John M
author_sort Wang, Michael
collection PubMed
description Cerebral edema following chimeric antigen receptor (CAR) T-cell therapy can be fatal. ZUMA-2 is a pivotal phase 2, multicenter study evaluating KTE-X19, an autologous anti-CD19 CAR T-cell therapy, in relapsed/refractory mantle cell lymphoma. We describe a 65-year-old patient in ZUMA-2 who developed cerebral edema following CAR T-cell therapy and had complete recovery after multimodality clinical intervention including rabbit antithymocyte globulin (ATG). Biomarker results show early and robust CAR T-cell expansion and related induction of inflammatory cytokines, followed by rapid declines in CAR T-cell and proinflammatory cytokine levels after ATG administration. This clinical profile highlights a potential relevance of ATG in treating severe CAR T-cell-related neurotoxicity.
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spelling pubmed-75702352020-10-21 Management of a patient with mantle cell lymphoma who developed severe neurotoxicity after chimeric antigen receptor T-cell therapy in ZUMA-2 Wang, Michael Jain, Preetesh Chi, T Linda Chen, Sheree E Heimberger, Amy Weathers, Shiao-Pei Zheng, Lianqing Rao, Arati V Rossi, John M J Immunother Cancer Case Report Cerebral edema following chimeric antigen receptor (CAR) T-cell therapy can be fatal. ZUMA-2 is a pivotal phase 2, multicenter study evaluating KTE-X19, an autologous anti-CD19 CAR T-cell therapy, in relapsed/refractory mantle cell lymphoma. We describe a 65-year-old patient in ZUMA-2 who developed cerebral edema following CAR T-cell therapy and had complete recovery after multimodality clinical intervention including rabbit antithymocyte globulin (ATG). Biomarker results show early and robust CAR T-cell expansion and related induction of inflammatory cytokines, followed by rapid declines in CAR T-cell and proinflammatory cytokine levels after ATG administration. This clinical profile highlights a potential relevance of ATG in treating severe CAR T-cell-related neurotoxicity. BMJ Publishing Group 2020-10-16 /pmc/articles/PMC7570235/ /pubmed/33067318 http://dx.doi.org/10.1136/jitc-2020-001114 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Case Report
Wang, Michael
Jain, Preetesh
Chi, T Linda
Chen, Sheree E
Heimberger, Amy
Weathers, Shiao-Pei
Zheng, Lianqing
Rao, Arati V
Rossi, John M
Management of a patient with mantle cell lymphoma who developed severe neurotoxicity after chimeric antigen receptor T-cell therapy in ZUMA-2
title Management of a patient with mantle cell lymphoma who developed severe neurotoxicity after chimeric antigen receptor T-cell therapy in ZUMA-2
title_full Management of a patient with mantle cell lymphoma who developed severe neurotoxicity after chimeric antigen receptor T-cell therapy in ZUMA-2
title_fullStr Management of a patient with mantle cell lymphoma who developed severe neurotoxicity after chimeric antigen receptor T-cell therapy in ZUMA-2
title_full_unstemmed Management of a patient with mantle cell lymphoma who developed severe neurotoxicity after chimeric antigen receptor T-cell therapy in ZUMA-2
title_short Management of a patient with mantle cell lymphoma who developed severe neurotoxicity after chimeric antigen receptor T-cell therapy in ZUMA-2
title_sort management of a patient with mantle cell lymphoma who developed severe neurotoxicity after chimeric antigen receptor t-cell therapy in zuma-2
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7570235/
https://www.ncbi.nlm.nih.gov/pubmed/33067318
http://dx.doi.org/10.1136/jitc-2020-001114
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