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A Case of Relapsed Primary Central Nervous System Lymphoma Treated with CD19-directed Chimeric Antigen Receptor T Cell Therapy

Although high-dose methotrexate (HD-MTX) is the standard therapy for primary central nervous system lymphoma (PCNSL), the prognosis remains poor. Because 90% of PCNSL is diffuse large B-cell lymphoma (DLBCL), chimeric antigen receptor (CAR)-T cell therapy is expected to be beneficial. However, there...

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Autores principales: MIZUTA, Ryo, OTANI, Yoshihiro, FUJII, Kentaro, UNEDA, Atsuhito, ISHIDA, Joji, TANAKA, Takehiro, IKEGAWA, Shuntaro, FUJII, Nobuharu, MAEDA, Yoshinobu, DATE, Isao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9512489/
https://www.ncbi.nlm.nih.gov/pubmed/36238605
http://dx.doi.org/10.2176/jns-nmc.2022-0134
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author MIZUTA, Ryo
OTANI, Yoshihiro
FUJII, Kentaro
UNEDA, Atsuhito
ISHIDA, Joji
TANAKA, Takehiro
IKEGAWA, Shuntaro
FUJII, Nobuharu
MAEDA, Yoshinobu
DATE, Isao
author_facet MIZUTA, Ryo
OTANI, Yoshihiro
FUJII, Kentaro
UNEDA, Atsuhito
ISHIDA, Joji
TANAKA, Takehiro
IKEGAWA, Shuntaro
FUJII, Nobuharu
MAEDA, Yoshinobu
DATE, Isao
author_sort MIZUTA, Ryo
collection PubMed
description Although high-dose methotrexate (HD-MTX) is the standard therapy for primary central nervous system lymphoma (PCNSL), the prognosis remains poor. Because 90% of PCNSL is diffuse large B-cell lymphoma (DLBCL), chimeric antigen receptor (CAR)-T cell therapy is expected to be beneficial. However, there are limited reports on CAR-T cell therapy for PCNSL because of the concern of neurotoxicity. Here, we report a case of relapsed PCNSL treated with anti-CD19 CAR-T cell therapy. A 40-year-old woman presenting with visual disturbance in her left eye was initially diagnosed with bilateral uveitis. Her histological diagnosis was DLBCL, and she was positive for CD19. Although she received chemotherapy including HD-MTX, the tumor relapsed in her right occipital lobe. She underwent remission induction therapy and then anti-CD19 CAR-T cell therapy. Cytokine release syndrome (CRS) grade 2 occurred, but there were no complications of CAR-T cell-related encephalopathy syndrome (CRES). She has achieved complete response for more than 1 year. Anti-CD19 CAR-T cell therapy is a revolutionary immunotherapy for treating relapsed or refractory (R/R) B lineage malignancies. Although there are concerns regarding CRS and CRES in central nervous system lymphoma, the use of anti-CD19 CAR-T cells to treat R/R PCNSL is safe and feasible.
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spelling pubmed-95124892022-10-12 A Case of Relapsed Primary Central Nervous System Lymphoma Treated with CD19-directed Chimeric Antigen Receptor T Cell Therapy MIZUTA, Ryo OTANI, Yoshihiro FUJII, Kentaro UNEDA, Atsuhito ISHIDA, Joji TANAKA, Takehiro IKEGAWA, Shuntaro FUJII, Nobuharu MAEDA, Yoshinobu DATE, Isao NMC Case Rep J Case Report Although high-dose methotrexate (HD-MTX) is the standard therapy for primary central nervous system lymphoma (PCNSL), the prognosis remains poor. Because 90% of PCNSL is diffuse large B-cell lymphoma (DLBCL), chimeric antigen receptor (CAR)-T cell therapy is expected to be beneficial. However, there are limited reports on CAR-T cell therapy for PCNSL because of the concern of neurotoxicity. Here, we report a case of relapsed PCNSL treated with anti-CD19 CAR-T cell therapy. A 40-year-old woman presenting with visual disturbance in her left eye was initially diagnosed with bilateral uveitis. Her histological diagnosis was DLBCL, and she was positive for CD19. Although she received chemotherapy including HD-MTX, the tumor relapsed in her right occipital lobe. She underwent remission induction therapy and then anti-CD19 CAR-T cell therapy. Cytokine release syndrome (CRS) grade 2 occurred, but there were no complications of CAR-T cell-related encephalopathy syndrome (CRES). She has achieved complete response for more than 1 year. Anti-CD19 CAR-T cell therapy is a revolutionary immunotherapy for treating relapsed or refractory (R/R) B lineage malignancies. Although there are concerns regarding CRS and CRES in central nervous system lymphoma, the use of anti-CD19 CAR-T cells to treat R/R PCNSL is safe and feasible. The Japan Neurosurgical Society 2022-09-03 /pmc/articles/PMC9512489/ /pubmed/36238605 http://dx.doi.org/10.2176/jns-nmc.2022-0134 Text en © 2022 The Japan Neurosurgical Society https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License.
spellingShingle Case Report
MIZUTA, Ryo
OTANI, Yoshihiro
FUJII, Kentaro
UNEDA, Atsuhito
ISHIDA, Joji
TANAKA, Takehiro
IKEGAWA, Shuntaro
FUJII, Nobuharu
MAEDA, Yoshinobu
DATE, Isao
A Case of Relapsed Primary Central Nervous System Lymphoma Treated with CD19-directed Chimeric Antigen Receptor T Cell Therapy
title A Case of Relapsed Primary Central Nervous System Lymphoma Treated with CD19-directed Chimeric Antigen Receptor T Cell Therapy
title_full A Case of Relapsed Primary Central Nervous System Lymphoma Treated with CD19-directed Chimeric Antigen Receptor T Cell Therapy
title_fullStr A Case of Relapsed Primary Central Nervous System Lymphoma Treated with CD19-directed Chimeric Antigen Receptor T Cell Therapy
title_full_unstemmed A Case of Relapsed Primary Central Nervous System Lymphoma Treated with CD19-directed Chimeric Antigen Receptor T Cell Therapy
title_short A Case of Relapsed Primary Central Nervous System Lymphoma Treated with CD19-directed Chimeric Antigen Receptor T Cell Therapy
title_sort case of relapsed primary central nervous system lymphoma treated with cd19-directed chimeric antigen receptor t cell therapy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9512489/
https://www.ncbi.nlm.nih.gov/pubmed/36238605
http://dx.doi.org/10.2176/jns-nmc.2022-0134
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