Allogeneic CAR-T bridging to allo-HSCT as a treatment strategy for refractory adult Burkitt's lymphoma: a case report.

Background: Epstein-Barr-virus-negative Burkitt's lymphoma (BL) is highly aggressive, and it is extremely rare that the lesion is confined to the uterine cervix at the time of diagnosis. Primary BL of the cervix lacks standardization of management due to its rarity. Autologous chimeric-antigen-receptor-T (CAR-T) cell therapy has achieved favourable outcomes in B cell malignant tumors, but the effect on BL is not satisfactory. With the continuous development of new technologies, allogeneic CAR-T cell therapy is constantly optimized, becoming safer and more effective, and it may become the first-line treatment option for malignant tumor cases with poor prognosis and insufficient treatment approaches. Case Description: A middle-aged Chinese female patient was admitted to the hospital for unexplained vaginal bleeding and cervical mass, and was diagnosed as primary BL of the cervix through pathological examination. After the failure of multi-line chemotherapy, the patient received donor-derived CD19/CD22 dual-targeted CAR-T cell therapy and achieved partial remission before bridging to allogeneic hematopoietic stem cell transplantation (allo-HSCT). Unfortunately, our patient eventually died of complications associated with allo-HSCT and septic shock before neutrophil and platelet implantation. Conclusions: The current results have confirmed that allogeneic CAR-T cells could provide better treatment opportunities for more patients. To our knowledge, this is the first report of allogeneic CAR-T cell therapy bridging to allo-HSCT in the treatment of primary BL of the cervix. And it provides a more treatment options for refractory adult BL.