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Case Report: Sirolimus Alleviates Persistent Cytopenia After CD19 CAR-T-Cell Therapy
Chimeric antigen receptor T (CAR-T) cells show good efficacy in the treatment of relapsed and refractory B-cell tumors, such as acute B-cell leukemia (ALL) and diffuse large B-cell lymphoma (DLBCL). The main toxicities of CAR-T include cytokine release syndrome, immune effector cell-associated neuro...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8733571/ https://www.ncbi.nlm.nih.gov/pubmed/35004324 http://dx.doi.org/10.3389/fonc.2021.798352 |
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author | Xing, Limin Wang, Yihao Liu, Hui Gao, Shan Shao, Qing Yue, Lanzhu Liu, Zhaoyun Wang, Huaquan Shao, Zonghong Fu, Rong |
author_facet | Xing, Limin Wang, Yihao Liu, Hui Gao, Shan Shao, Qing Yue, Lanzhu Liu, Zhaoyun Wang, Huaquan Shao, Zonghong Fu, Rong |
author_sort | Xing, Limin |
collection | PubMed |
description | Chimeric antigen receptor T (CAR-T) cells show good efficacy in the treatment of relapsed and refractory B-cell tumors, such as acute B-cell leukemia (ALL) and diffuse large B-cell lymphoma (DLBCL). The main toxicities of CAR-T include cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, cytopenia, and severe infection. It is still very difficult for CAR-T to kill tumor cells to the maximum extent and avoid damaging normal organs. Here, we report a case of DLBCL with persistent grade 4 thrombocytopenia and severe platelet transfusion dependence treated with CD19 CAR-T cells. We used sirolimus to inhibit the sustained activation of CAR-T cells and restore normal bone marrow hematopoiesis and peripheral blood cells. Moreover, sirolimus treatment did not affect the short-term efficacy of CAR-T cells, and DLBCL was in complete remission at the end of follow-up. In conclusion, sirolimus can represent a new strategy for the management of CAR-T cell therapy-related toxicity, including but not limited to hematotoxicity. However, further controlled clinical studies are required to confirm these findings. |
format | Online Article Text |
id | pubmed-8733571 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-87335712022-01-07 Case Report: Sirolimus Alleviates Persistent Cytopenia After CD19 CAR-T-Cell Therapy Xing, Limin Wang, Yihao Liu, Hui Gao, Shan Shao, Qing Yue, Lanzhu Liu, Zhaoyun Wang, Huaquan Shao, Zonghong Fu, Rong Front Oncol Oncology Chimeric antigen receptor T (CAR-T) cells show good efficacy in the treatment of relapsed and refractory B-cell tumors, such as acute B-cell leukemia (ALL) and diffuse large B-cell lymphoma (DLBCL). The main toxicities of CAR-T include cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, cytopenia, and severe infection. It is still very difficult for CAR-T to kill tumor cells to the maximum extent and avoid damaging normal organs. Here, we report a case of DLBCL with persistent grade 4 thrombocytopenia and severe platelet transfusion dependence treated with CD19 CAR-T cells. We used sirolimus to inhibit the sustained activation of CAR-T cells and restore normal bone marrow hematopoiesis and peripheral blood cells. Moreover, sirolimus treatment did not affect the short-term efficacy of CAR-T cells, and DLBCL was in complete remission at the end of follow-up. In conclusion, sirolimus can represent a new strategy for the management of CAR-T cell therapy-related toxicity, including but not limited to hematotoxicity. However, further controlled clinical studies are required to confirm these findings. Frontiers Media S.A. 2021-12-23 /pmc/articles/PMC8733571/ /pubmed/35004324 http://dx.doi.org/10.3389/fonc.2021.798352 Text en Copyright © 2021 Xing, Wang, Liu, Gao, Shao, Yue, Liu, Wang, Shao and Fu https://creativecommons.org/licenses/by/4.0/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) and the copyright owner(s) 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. |
spellingShingle | Oncology Xing, Limin Wang, Yihao Liu, Hui Gao, Shan Shao, Qing Yue, Lanzhu Liu, Zhaoyun Wang, Huaquan Shao, Zonghong Fu, Rong Case Report: Sirolimus Alleviates Persistent Cytopenia After CD19 CAR-T-Cell Therapy |
title | Case Report: Sirolimus Alleviates Persistent Cytopenia After CD19 CAR-T-Cell Therapy |
title_full | Case Report: Sirolimus Alleviates Persistent Cytopenia After CD19 CAR-T-Cell Therapy |
title_fullStr | Case Report: Sirolimus Alleviates Persistent Cytopenia After CD19 CAR-T-Cell Therapy |
title_full_unstemmed | Case Report: Sirolimus Alleviates Persistent Cytopenia After CD19 CAR-T-Cell Therapy |
title_short | Case Report: Sirolimus Alleviates Persistent Cytopenia After CD19 CAR-T-Cell Therapy |
title_sort | case report: sirolimus alleviates persistent cytopenia after cd19 car-t-cell therapy |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8733571/ https://www.ncbi.nlm.nih.gov/pubmed/35004324 http://dx.doi.org/10.3389/fonc.2021.798352 |
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