Department of Hematology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Front Immunol. 2022 Jan 27;13:778192. doi: 10.3389/fimmu.2022.778192. eCollection 2022.
Chimeric antigen receptor-modified T cells (CAR-T) targeting CD19 has produced a high durable response in refractory or relapsed diffuse large B-cell lymphoma. Besides well-known cytokine release syndrome (CRS) or immune effector cell-associated neurotoxicity syndrome during CAR-T cell therapy, there were several rarely encountered fatal complications.
A 63-year-old male patient with refractory EBV-positive diffuse large B-cell lymphoma, developed interstitial pneumonitis with prolonged hypoxemia at 16 weeks after CD19 CAR-T cell therapy. There was no evidence of CRS and any infections. The patient recovered after intravenous immunoglobulin without tocilizumab or glucocorticoid administration. Now he is still in remission without interstitial pneumonitis 3 years after CAR-T cell therapy.
This is the first report of immunotherapy-associated interstitial pneumonitis after CAR-T cell therapy. Our finding suggested the importance of careful follow-up and proper treatments for immunotherapy-associated pneumonitis in the CAR-T cell therapy schedule.
嵌合抗原受体修饰的 T 细胞（CAR-T）针对 CD19 的治疗在难治或复发弥漫性大 B 细胞淋巴瘤中产生了高持久性反应。除了在 CAR-T 细胞治疗期间众所周知的细胞因子释放综合征（CRS）或免疫效应细胞相关神经毒性综合征外，还有一些罕见的致命并发症。
一名 63 岁男性患者患有难治性 EBV 阳性弥漫性大 B 细胞淋巴瘤，在 CD19 CAR-T 细胞治疗后 16 周出现间质性肺炎伴长时间低氧血症。没有 CRS 和任何感染的证据。患者在未使用托珠单抗或糖皮质激素的情况下接受静脉注射免疫球蛋白后康复。现在，CAR-T 细胞治疗 3 年后，他仍然没有间质性肺炎，处于缓解状态。
这是 CAR-T 细胞治疗后免疫治疗相关间质性肺炎的首例报告。我们的发现表明，在 CAR-T 细胞治疗计划中，对免疫治疗相关肺炎进行仔细随访和适当治疗非常重要。
