Juan Du1, Yonghong Zhang2. 1. Tianjin Medical University, Tianjin, 300070, China. 2. Children's Lymphoma Ward, Beijing Boren Hospital, Beijing, 100070, China. yhzhang58@126.com.
Abstract
PURPOSE: Burkitt lymphoma (BL) is one of the most frequent subtypes of non-Hodgkin lymphoma (NHL) in children. Currently, short, intensive chemotherapy is used internationally and has greatly improved survival in children with BL. However, 5-10% of patients suffer recurrence after intensive chemotherapy, and the prognosis of these patients remains poor. The overall survival rate is only approximately 10%. Innovative therapies are needed to attain a higher rate of remission, such as immunotherapy for relapsed refractory (r/r) BL patients. METHODS: An 8-year-old boy with BL was studied. He suffered a relapse after treatment with standard chemotherapy. Then, we treated this patient using autologous chimeric antigen receptor T-cell (CAR-T) therapies, sequentially targeting antigens CD19, CD22, and CD20. A review of the current literature on CAR-T treatment for lymphoma is presented. RESULTS: The patient had no discernible response to anti-CD19 CAR-T treatment and exhibited progressive disease (PD). Following CD-22-directed CAR-T treatment, the patient underwent a partial remission (PR), but unfortunately a relapse rapidly occurred. Finally, after administering the anti-CD20 CAR-T cell therapy, the child went into complete remission (CR). The young boy has currently achieved 16-month event-free survival (EFS) so far. During administration of the CD19 and CD20 CAR-T cells, the patient appeared to experience mild (Grade I) cytokine release syndrome (CRS). However, during the CD22 CAR-T therapy, he appeared to experience grade III CRS. CONCLUSION: Autologous anti-CD19, anti-CD22, and anti-CD20 CAR-T cell therapies targeting multiple tumor antigens could be an innovative and sound treatment for children with r/r BL, provided that they are closely monitored during treatment.
PURPOSE:Burkitt lymphoma (BL) is one of the most frequent subtypes of non-Hodgkin lymphoma (NHL) in children. Currently, short, intensive chemotherapy is used internationally and has greatly improved survival in children with BL. However, 5-10% of patients suffer recurrence after intensive chemotherapy, and the prognosis of these patients remains poor. The overall survival rate is only approximately 10%. Innovative therapies are needed to attain a higher rate of remission, such as immunotherapy for relapsed refractory (r/r) BLpatients. METHODS: An 8-year-old boy with BL was studied. He suffered a relapse after treatment with standard chemotherapy. Then, we treated this patient using autologous chimeric antigen receptor T-cell (CAR-T) therapies, sequentially targeting antigens CD19, CD22, and CD20. A review of the current literature on CAR-T treatment for lymphoma is presented. RESULTS: The patient had no discernible response to anti-CD19CAR-T treatment and exhibited progressive disease (PD). Following CD-22-directed CAR-T treatment, the patient underwent a partial remission (PR), but unfortunately a relapse rapidly occurred. Finally, after administering the anti-CD20CAR-T cell therapy, the child went into complete remission (CR). The young boy has currently achieved 16-month event-free survival (EFS) so far. During administration of the CD19 and CD20CAR-T cells, the patient appeared to experience mild (Grade I) cytokine release syndrome (CRS). However, during the CD22CAR-T therapy, he appeared to experience grade III CRS. CONCLUSION: Autologous anti-CD19, anti-CD22, and anti-CD20CAR-T cell therapies targeting multiple tumor antigens could be an innovative and sound treatment for children with r/r BL, provided that they are closely monitored during treatment.
Authors: Samantha J Seitter; Paul H McClelland; Mark A Ahlman; Stephanie L Goff; James C Yang; Lori McIntyre; Steven A Rosenberg; James N Kochenderfer; Jennifer N Brudno Journal: Leuk Lymphoma Date: 2022-06-09