EBV-associated lymphoproliferative disease post-CAR-T cell therapy

作者：Zhang, Shiyuan; Zhou, Xiaoxi; Zhang, Shangkun; Wang, Na; Zhang, Tongcun; Zhang, Donghua; Ao, Qilin^*; Cao, Yang^*; Huang, Liang^*

来源：Frontiers of Medicine, 2024.

DOI：10.1007/s11684-023-1032-8

• EBV-associated lymphoproliferative disease
• chimeric antigen receptor T-cell
• autologous stem cell transplantation
• immune checkpoint inhibitor

Epstein-Barr virus (EBV)-associated lymphoproliferative diseases (EBV-LPDs) are common complications that occur after solid organ transplantation or allogeneic hematopoietic stem-cell transplantation (HSCT). However, their occurrence and treatment post-chimeric antigen receptor-modified T (CAR-T) cell therapy has not been reported. Two patients had been diagnosed with EBV-positive aggressive B-cell lymphoma and experienced relapses after multiple lines of treatment. After receiving CAR-T cell therapy in tandem with autologous HSCT, the patients achieved complete remission. However, with a median time of 38.5 months after CAR-T cell therapy, B-cell-derived EBV-LPDs were diagnosed, and they were relieved through the administration of immune checkpoint inhibitor or B-cell-depleting agents. Collectively, our report suggests that EBV-LPDs may represent a long-term adverse event after CAR-T cell therapy, especially in patients who previously had EBV-positive disorders, and they can be resolved by immune normalization strategy or B-cell depleting therapy.

• 单位
  华中科技大学; 中国医学科学院北京协和医院; y