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Cardiac involvement in a patient with B-cell lymphoblastic lymphoma/acute lymphoblastic leukemia and a history of allogeneic hematopoietic stem cell transplantation and CAR T-cell therapy: A case report

Cardiac involvement in hematological malignancies is uncommon, with only a few cases reported to date, and it often leads to a poor prognosis. Here, we report a case of a 42-year-old woman with a history of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and anti-CD19 chimeric antigen...

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Autores principales: Cao, Yigeng, Liu, Yadan, Zhang, Rongli, Zhai, Weihua, Ma, Qiaoling, Wei, Jialin, Yang, Donglin, Pang, Aiming, He, Yi, Chen, Xin, Jiang, Erlie, Feng, Sizhou, Han, Mingzhe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9849371/
https://www.ncbi.nlm.nih.gov/pubmed/36685607
http://dx.doi.org/10.3389/fimmu.2022.1052336
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author Cao, Yigeng
Liu, Yadan
Zhang, Rongli
Zhai, Weihua
Ma, Qiaoling
Wei, Jialin
Yang, Donglin
Pang, Aiming
He, Yi
Chen, Xin
Jiang, Erlie
Feng, Sizhou
Han, Mingzhe
author_facet Cao, Yigeng
Liu, Yadan
Zhang, Rongli
Zhai, Weihua
Ma, Qiaoling
Wei, Jialin
Yang, Donglin
Pang, Aiming
He, Yi
Chen, Xin
Jiang, Erlie
Feng, Sizhou
Han, Mingzhe
author_sort Cao, Yigeng
collection PubMed
description Cardiac involvement in hematological malignancies is uncommon, with only a few cases reported to date, and it often leads to a poor prognosis. Here, we report a case of a 42-year-old woman with a history of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and anti-CD19 chimeric antigen receptor (CAR) T-cell therapy for B-cell lymphoblastic lymphoma/acute lymphoblastic leukemia in whom cardiac mass and myocardial infiltration were detected. Prior to this presentation, massive pericardial effusion had occurred 6 months after CAR T-cell therapy, which was improved via ultrasound-guided pericardiocentesis. We observed elevated cytokine levels and increased copy number of CAR DNA in both pericardial effusion and serum. Upon detecting cardiac mass and myocardial infiltration, the patient was administered tocilizumab (a humanized monoclonal antibody against IL-6 receptor), which controlled the serum cytokine levels, and reduced intensity chemotherapy, including vindesine, cyclophosphamide, and prednisolone. However, the patient finally died of multiple organ failure. To the best of our knowledge, this is the first report on the development of a cardiac mass and occurrence of myocardial infiltration after allo-HSCT and CAR T-cell therapy. This report may provide supporting data for the early diagnosis and immediate treatment of patients with cardiac involvement.
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spelling pubmed-98493712023-01-20 Cardiac involvement in a patient with B-cell lymphoblastic lymphoma/acute lymphoblastic leukemia and a history of allogeneic hematopoietic stem cell transplantation and CAR T-cell therapy: A case report Cao, Yigeng Liu, Yadan Zhang, Rongli Zhai, Weihua Ma, Qiaoling Wei, Jialin Yang, Donglin Pang, Aiming He, Yi Chen, Xin Jiang, Erlie Feng, Sizhou Han, Mingzhe Front Immunol Immunology Cardiac involvement in hematological malignancies is uncommon, with only a few cases reported to date, and it often leads to a poor prognosis. Here, we report a case of a 42-year-old woman with a history of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and anti-CD19 chimeric antigen receptor (CAR) T-cell therapy for B-cell lymphoblastic lymphoma/acute lymphoblastic leukemia in whom cardiac mass and myocardial infiltration were detected. Prior to this presentation, massive pericardial effusion had occurred 6 months after CAR T-cell therapy, which was improved via ultrasound-guided pericardiocentesis. We observed elevated cytokine levels and increased copy number of CAR DNA in both pericardial effusion and serum. Upon detecting cardiac mass and myocardial infiltration, the patient was administered tocilizumab (a humanized monoclonal antibody against IL-6 receptor), which controlled the serum cytokine levels, and reduced intensity chemotherapy, including vindesine, cyclophosphamide, and prednisolone. However, the patient finally died of multiple organ failure. To the best of our knowledge, this is the first report on the development of a cardiac mass and occurrence of myocardial infiltration after allo-HSCT and CAR T-cell therapy. This report may provide supporting data for the early diagnosis and immediate treatment of patients with cardiac involvement. Frontiers Media S.A. 2023-01-05 /pmc/articles/PMC9849371/ /pubmed/36685607 http://dx.doi.org/10.3389/fimmu.2022.1052336 Text en Copyright © 2023 Cao, Liu, Zhang, Zhai, Ma, Wei, Yang, Pang, He, Chen, Jiang, Feng and Han 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 Immunology
Cao, Yigeng
Liu, Yadan
Zhang, Rongli
Zhai, Weihua
Ma, Qiaoling
Wei, Jialin
Yang, Donglin
Pang, Aiming
He, Yi
Chen, Xin
Jiang, Erlie
Feng, Sizhou
Han, Mingzhe
Cardiac involvement in a patient with B-cell lymphoblastic lymphoma/acute lymphoblastic leukemia and a history of allogeneic hematopoietic stem cell transplantation and CAR T-cell therapy: A case report
title Cardiac involvement in a patient with B-cell lymphoblastic lymphoma/acute lymphoblastic leukemia and a history of allogeneic hematopoietic stem cell transplantation and CAR T-cell therapy: A case report
title_full Cardiac involvement in a patient with B-cell lymphoblastic lymphoma/acute lymphoblastic leukemia and a history of allogeneic hematopoietic stem cell transplantation and CAR T-cell therapy: A case report
title_fullStr Cardiac involvement in a patient with B-cell lymphoblastic lymphoma/acute lymphoblastic leukemia and a history of allogeneic hematopoietic stem cell transplantation and CAR T-cell therapy: A case report
title_full_unstemmed Cardiac involvement in a patient with B-cell lymphoblastic lymphoma/acute lymphoblastic leukemia and a history of allogeneic hematopoietic stem cell transplantation and CAR T-cell therapy: A case report
title_short Cardiac involvement in a patient with B-cell lymphoblastic lymphoma/acute lymphoblastic leukemia and a history of allogeneic hematopoietic stem cell transplantation and CAR T-cell therapy: A case report
title_sort cardiac involvement in a patient with b-cell lymphoblastic lymphoma/acute lymphoblastic leukemia and a history of allogeneic hematopoietic stem cell transplantation and car t-cell therapy: a case report
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9849371/
https://www.ncbi.nlm.nih.gov/pubmed/36685607
http://dx.doi.org/10.3389/fimmu.2022.1052336
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