School of Medicine, Stanford University, Stanford, California.
Department of Radiation Oncology, Stanford University, Stanford, California.
Pediatr Blood Cancer. 2021 Mar;68(3):e28870. doi: 10.1002/pbc.28870. Epub 2020 Dec 23.
The use of radiotherapy as bridging therapy to chimeric antigen receptor T-cell therapy (CAR-T) in pre-B acute lymphoblastic leukemia (B-ALL) has been minimally explored. Here, we present a boy with B-ALL who relapsed after allogeneic bone marrow transplant with disseminated disease, including significant symptomatic cardiovascular and gastrointestinal (GI) involvement. The cardiac and GI leukemic infiltrates were successfully treated with bridging radiation therapy (BRT) prior to CAR-T infusion. Using this approach, he successfully tolerated CAR-T with no evidence of disease or sequelae on 3-month follow-up. This is the first reported case of safe and effective delivery of cardiac BRT in B-ALL.
放疗作为嵌合抗原受体 T 细胞疗法（CAR-T）在 pre-B 急性淋巴细胞白血病（B-ALL）中的桥接治疗的应用尚未得到充分探索。在此，我们介绍了一例 B-ALL 男孩，他在异基因骨髓移植后复发，伴有弥散性疾病，包括明显有症状的心血管和胃肠道（GI）受累。心脏和 GI 白血病浸润在 CAR-T 输注前成功地接受了桥接放疗（BRT）治疗。通过这种方法，他成功地耐受了 CAR-T，在 3 个月的随访中没有疾病或后遗症的证据。这是首例报道的在 B-ALL 中安全有效地进行心脏 BRT 的病例。
