Takhar Jaskirat S, Mehra Ankur A, Kurup Shree K, Sobol Warren M, Aslam Rabail, Oduro Kwadwo A, Echegaray Jose J
University Hospitals Eye Institute, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
J Vitreoretin Dis. 2024 Aug 31:24741264241275247. doi: 10.1177/24741264241275247.
To present a case of acute B-cell lymphoblastic leukemia (B-ALL) ocular relapse treated with chimeric antigen receptor T-cell (CAR T) therapy. A retrospective case review was evaluated. A 69-year-old woman with a history of BALL presented with bilateral hypopyons and 3+ anterior chamber cells that responded to topical prednisolone. Six months later, she developed recurrent hypopyons, iris neovascularization, and iris nodularity in both eyes. A fine-needle aspiration biopsy confirmed ocular infiltration of B-ALL. A single infusion of CAR T therapy resulted in remission of the systemic and ocular findings. The clinical course was complicated by cytokine release syndrome and neurotoxicity, which improved with medical management. The patient remained in remission for 7 months after a single CAR T infusion. CAR T therapy may be effective in treating systemic leukemia and uveal infiltration, with an ocular side-effect profile and visual outcomes. The systemic side effects of CAR T therapy may be managed medically.
介绍一例采用嵌合抗原受体T细胞（CAR T）疗法治疗的急性B淋巴细胞白血病（B-ALL）眼部复发病例。进行了一项回顾性病例分析。一名有B-ALL病史的69岁女性出现双侧前房积脓和3+前房细胞，局部应用泼尼松龙后有反应。6个月后，她双眼再次出现前房积脓、虹膜新生血管和虹膜结节。细针穿刺活检证实B-ALL眼部浸润。单次输注CAR T疗法使全身和眼部症状缓解。临床过程中出现了细胞因子释放综合征和神经毒性并发症，经药物治疗后有所改善。单次输注CAR T后，患者缓解了7个月。CAR T疗法可能对治疗全身性白血病和葡萄膜浸润有效，且具有眼部副作用特征和视觉预后。CAR T疗法的全身性副作用可以通过药物治疗。
