Evidence map›Paper›PMID 38854403›Full record

ArticleBlood cell therapy2024

A case of successful CAR-T cell therapy for early isolated CNS recurrence of DLBCL with persistent CAR-T cells.

Ken Takigawa, Noriaki Kawano, Yasuo Mori, Takuji Yamauchi, Taro Tochigi, Kohta Miyawaki, Kyohei Mori, Masatoshi Shimo, Takashi Nakaike, Kiyoshi Yamashita and 6 more

Abstract readCase Reports
In one paragraph

Article in Blood cell therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Ken TakigawaDepartment of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan.
Noriaki KawanoDepartment of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan.
Yasuo MoriDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan.
Takuji YamauchiDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan.
Taro TochigiDepartment of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan.
Kohta MiyawakiDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan.
Kyohei MoriDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan.
Masatoshi ShimoDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan.
Takashi NakaikeDepartment of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan.
Kiyoshi YamashitaDepartment of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan.
Koichi MashibaDepartment of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan.
Ikuo KikuchiDepartment of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan.
Kousuke MarutsukaDepartment of Pathology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan.
Koichi OhshimaDepartment of Pathology, Kurume University, Fukuoka, Japan.
Koji KatoDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan.
Koichi AkashiDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Secondary central nervous system (CNS) lymphomas typically require CNS-penetrating drugs; however, the available agents are limited with temporary effects and poor outcomes. Chimeric antigen receptor T (CAR-T) cell therapy (lisocabtagene maraleucel; liso-cel) has been used to treat a few cases of isolated secondary CNS lymphoma. Herein, we report the case of a 66-year-old male diagnosed with diffuse large B-cell lymphoma (Ann Arbor grade IV; R-IPI, good risk; CNS IPI: Intermediate risk) who achieved complete remission (CR) after six courses of R-CHOP therapy. Three months later, he presented with ptosis and eye movement disorder. Systemic CT and bone marrow examination revealed no lymphoma. Although cranial-enhanced MRI showed normal findings, an increased number of B-cells (51/μL) with the original lymphoma phenotype (CD19+CD79a+CD5-CD10-CD20-Igλ+) was detected in cerebrospinal fluid (CSF), indicating an isolated CNS relapse. Seven high-dose methotrexate courses led to partial response. Subsequently, the patient received CAR-T cell therapy with tolerable adverse events - cytokine release syndrome treated with tocilizumab, no immune effector cell-associated neurotoxicity syndrome, and bone marrow failure treated with granulocyte-colony stimulating factor and eltrombopag. Sequential flow cytometry revealed a high peak of CAR-T cells and the presence of residual CAR-T cells in the peripheral blood, indicating immune surveillance of CNS lymphoma by CAR-T cells. This treatment led to a second CR. This case is the first to validate the efficacy and safety of CAR-T cell therapy for isolated secondary CNS lymphoma in clinical practice. Future accumulation of evidence on the efficacy and safety of CAR-T cell therapy is essential.

Indexed as

CAR-T cell therapyCNS lymphomaCRSdynamics of CAR-T cells in PBICANS

Identifiers

PMID38854403
PMCPMC11153208

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.