西达基奥仑赛（cilta-cel）CAR-T 细胞治疗后惰性 CD4+ CAR T 细胞淋巴瘤。

Indolent CD4+ CAR T-Cell Lymphoma after Cilta-cel CAR T-Cell Therapy.

机构信息

From the Departments of Pathology (M.O., J.J.C.) and Gastroenterology (T.M.L.), MedStar Georgetown University Hospital, and Lombardi Comprehensive Cancer Center, Georgetown University Medical Center (E.D., A.U.) - both in Washington, DC; the Genomic Testing Cooperative, Irvine, CA (M.A.); the National Institutes of Health, Bethesda, MD (S.P.); and Brigham and Women's Hospital (S.S.), the Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute (K.C.A.), and Harvard Medical School (P.A.) - all in Boston.

出版信息

N Engl J Med. 2024 Jun 13;390(22):2074-2082. doi: 10.1056/NEJMoa2401530.

DOI:10.1056/NEJMoa2401530

PMID:38865661

Abstract

Indolent CD4+ cytotoxic chimeric antigen receptor (CAR) T-cell lymphoma involving the small intestine was diagnosed in a patient who had previously received ciltacabtagene autoleucel (cilta-cel) CAR T-cell therapy for treatment of myeloma. Targeted messenger RNA sequencing revealed the presence of CAR gene product in tumor cells. Whole-genome sequencing of samples of tumor and peripheral blood identified a single lentiviral insertion site within the second intron of the gene. In addition, numerous genetic alterations that may have contributed to malignant transformation were identified in the tumor sample. (Funded by MedStar Georgetown University Hospital.).

摘要

一位曾接受 cilta-cel（嵌合抗原受体 T 细胞）CAR 疗法治疗多发性骨髓瘤的患者，诊断出患有惰性 CD4+ 细胞毒性嵌合抗原受体（CAR）T 细胞淋巴瘤，累及小肠。靶向信使 RNA 测序显示肿瘤细胞中存在 CAR 基因产物。肿瘤和外周血样本的全基因组测序确定了基因第二个内含子内单个慢病毒插入位点。此外，在肿瘤样本中还鉴定出许多可能导致恶性转化的遗传改变。（由 MedStar Georgetown University Hospital 资助）。