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[1例难治性快速进展性疾病套细胞淋巴瘤患者的CAR-T细胞治疗成功:病例报告]

[Successful CAR-T cell therapy in a refractory mcl patient with rapidly progressive disease: a case report].

作者信息

Farina Mirko, Re Alessandro

机构信息

Unità Trapianto di Midollo Osseo per Adulti; Programma di ricerca in ematologia e terapie cellulari, Dipartimento di Scienze cliniche e sperimentali, Università di Brescia, Asst Spedali Civili di Brescia.

Unità operativa di ematologia, Asst Spedali Civili di Brescia.

出版信息

Recenti Prog Med. 2025 Mar;116(3):e40-e44. doi: 10.1701/4460.44568.

DOI:10.1701/4460.44568
PMID:40084458
Abstract

Mantle cell lymphoma is a rare and aggressive hematologic malignancy characterized by frequent relapses and poor prognosis. Recently, the approval of CAR-T cell therapy has transformed the treatment landscape for relapsed/refractory patients. We report the case of a 52-year-old patient with mantle cell lymphoma who experienced multiple disease relapses. Specifically, the patient showed a rapid and severe progression after treatment with BTK inhibitors in the second line of therapy and was subsequently evaluated for a CAR-T cell therapy program. This case highlights the importance of a multidisciplinary approach, with efficient collaboration optimizing timelines for treatment eligibility, leukapheresis planning, bridge therapy, and CAR-T cell infusion (brexu-cel). The CAR-T treatment was well tolerated, although it was associated with a rare cardiovascular complication, sinus bradycardia, and subsequently, a deep vein thrombosis. Thanks to close collaboration with cardiology specialists, these complications were resolved without sequelae. Post CAR-T cell therapy, the patient achieved complete remission, sustained at 15 months of follow-up.

摘要

套细胞淋巴瘤是一种罕见且侵袭性的血液系统恶性肿瘤,其特征为频繁复发且预后不良。最近,CAR-T细胞疗法的获批改变了复发/难治性患者的治疗格局。我们报告了一例52岁套细胞淋巴瘤患者,该患者经历了多次疾病复发。具体而言,该患者在二线治疗中接受BTK抑制剂治疗后出现快速且严重的病情进展,随后接受了CAR-T细胞治疗方案的评估。该病例凸显了多学科方法的重要性,通过高效协作优化了治疗资格评估、白细胞分离术规划、桥接治疗和CAR-T细胞输注(brexu-cel)的时间安排。尽管CAR-T治疗与一种罕见的心血管并发症——窦性心动过缓以及随后的深静脉血栓形成相关,但患者对该治疗耐受性良好。由于与心脏病专家密切合作,这些并发症得以解决且无后遗症。CAR-T细胞治疗后,患者实现完全缓解,并在15个月的随访中持续保持。

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