Chimeric antigen receptor (CAR) T-cell immunotherapy following autologous stem cell transplantation (ASCT) is a promising method for refractory or relapsed multiple myeloma, but explicit data for central nervous system lymphoma (CNSL) are lacking. Here, we treated 13 CNSL patients with ASCT sequential CD19/22 CAR T-cell infusion and simultaneously evaluated the clinical efficacy and toxicity. The 13 CNSL patients analyzed included four primary CNSL and nine secondary CNSL patients. Patients 1 and 10, who had complete remission status before enrollment, maintained clinical efficacy without recurrence. Nine of the remaining 11 patients responded to our protocol with a median durable time of 14.03 months, and the overall response and complete remission rate were 81.81% and 54.55%, respectively. No patient suffered grades 3–4 cytokine-release syndrome (CRS), and only patient 10 experienced severe immune effector cell-associated neurotoxicity syndrome (ICANS). In addition, increases in serum ferritin and interleukin-6 levels were often accompanied by CRS and ICANS. After a median follow-up time of 14.20 months, the estimated 1-year progression-free survival and overall survival rates were 74.59% and 82.50%, respectively. Sequential CD19/22 CAR T-cell immunotherapy following ASCT as a novel method for CNSL appears to have encouraging long-term efficacy with relatively manageable side effects.
自体干细胞移植（ASCT）序贯CD19/22嵌合抗原受体（CAR）T细胞免疫疗法是难治性或复发性多发性骨髓瘤的一种前景广阔的治疗方法，但其对中枢神经系统淋巴瘤（CNSL）的疗效尚缺乏明确数据。本研究对13例CNSL患者采用ASCT序贯CD19/22 CAR T细胞输注治疗，并同步评估临床疗效与毒性反应。纳入分析的13例CNSL患者包括4例原发性CNSL和9例继发性CNSL。入组前已达完全缓解状态的患者1和患者10在治疗后持续保持疗效且无复发。其余11例患者中，有9例对本方案产生应答，中位缓解持续时间为14.03个月，总体缓解率和完全缓解率分别为81.81%和54.55%。无患者出现3-4级细胞因子释放综合征（CRS），仅患者10发生重度免疫效应细胞相关神经毒性综合征（ICANS）。此外，血清铁蛋白和白介素-6水平升高常伴随CRS和ICANS发生。中位随访14.20个月后，预计1年无进展生存率和总生存率分别为74.59%和82.50%。ASCT后序贯CD19/22 CAR T细胞免疫疗法作为CNSL的新型治疗策略，显示出令人鼓舞的长期疗效及相对可控的副作用。
肿瘤(癌症)患者之家