CAR T-cell Infusion Following Checkpoint Inhibition Can Induce Remission in Chemorefractory Post-transplant Lymphoproliferative Disorder of the CNS

作者：Wiebke Rösler, A. Bink, M. Bissig, Lukas Imbach, E. Marques Maggio, M. Manz, T. Müller, P. Roth, Elisabeth J. Rushing, C. Widmer, T. Zenz, S. von Moos, A. Müller · 发表于：HemaSphere · 年份：2022 · DOI：10.1097/HS9.0000000000000733 · 被引用次数：13 · 研究领域：Medicine

. W e present the successful treatment of a patient with post-transplant lymphoproliferative disorder (PTLD) of the central nervous system (CNS) with checkpoint inhibition, followed by infusion of chimeric antigen receptor T cells (CAR-T). CD19-directed CAR-T cells are an effective treatment option for patients with relapsed/ refractory (r/r) aggressive B-cell lymphoma. Although some first experience of the use of CAR-T cells in patients with CNS lymphoma has been published, reports on the treatment of PTLD with CAR-T are scarce. In addition to our case, we provide a review of the available literature on the treatment of CNS lymphoma and PTLD with CAR-T cells. CAR-T cells targeting CD19 are currently approved for patients with r/r diffuse large B-cell lymphoma (DLBCL), high-grade and primary mediastinal B-cell lymphoma after > 2 lines of chemotherapy. In early studies and in phase I/II clinical trials, cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) were frequently observed. 1,2 Although patients with active lymphoma of the CNS were excluded from most clinical CAR-T trials, there is now growing evidence for the use of CAR-T in these patients without evidence of increased neurotoxicity. 3–6 CAR-T therapy for treatment