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首例弥漫性大B细胞淋巴瘤治疗5年后持续性嵌合抗原受体T细胞(CAR T细胞)的女性自然健康怀孕病例。

First reported case of a spontaneous and healthy pregnancy in a woman with persistent CAR T-cells 5 years after treatment for diffuse large B-cell lymphoma.

作者信息

Canty Ethan Abraham, Broderick Lori, Flaherty Daniel, Xavier Marin, Nasta Sunita D, Dajani Lina, White Andrew A

机构信息

Allergy, Asthma and Immunology, Scripps Green Hospital, La Jolla, California, USA

Allergy and Immunology, Rady Children's Hospital, San Diego, California, USA.

出版信息

J Immunother Cancer. 2025 Apr 1;13(4):e011092. doi: 10.1136/jitc-2024-011092.

Abstract

Chimeric antigen receptor T-cell (CAR T-cell) therapy has significantly advanced cancer treatments and remission rates; however, questions exist regarding the impacts on both fertility and immune effects on infants born to mothers who have undergone CAR T-cell therapy. There are no known reported cases of persistence of CAR T-cells after cancer therapy in pregnancy. Here, we present a case of a woman with relapsed refractory diffuse large B-cell lymphoma who undertook an experimental CAR T-cell therapy, had persistence of CAR T-cells 5 years after achieving remission, spontaneously became pregnant and delivered a healthy male infant. Our case provides an example of a healthy pregnancy despite the persistence of CAR T-cells and the resultant healthy newborn without evidence of immunologic or other health effects from the CAR T-cells.

摘要

嵌合抗原受体T细胞(CAR T细胞)疗法显著推动了癌症治疗并提高了缓解率;然而,对于接受过CAR T细胞疗法的母亲所生婴儿的生育能力和免疫影响仍存在疑问。目前尚无癌症治疗后妊娠期间CAR T细胞持续存在的报道病例。在此,我们报告一例复发性难治性弥漫性大B细胞淋巴瘤女性患者,她接受了实验性CAR T细胞疗法,缓解后5年CAR T细胞持续存在,随后自然受孕并产下一名健康男婴。我们的病例提供了一个尽管CAR T细胞持续存在但仍实现健康妊娠且新生儿健康的例子,未发现CAR T细胞产生免疫或其他健康影响的证据。

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Fertility and CAR T-cells: Current practice and future directions.生育能力与 CAR T 细胞:当前实践与未来方向。
Transplant Cell Ther. 2022 Sep;28(9):605.e1-605.e8. doi: 10.1016/j.jtct.2022.06.002. Epub 2022 Jun 12.
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Lancet Oncol. 2021 Dec;22(12):e550-e561. doi: 10.1016/S1470-2045(21)00525-8.

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