Chimeric antigen receptor T-cell therapy after COVID-19 in refractory high-grade B-cell lymphoma.
Int J Hematol
; 119(4): 459-464, 2024 Apr.
Article
in En
| MEDLINE
| ID: mdl-38349446
ABSTRACT
Although chimeric antigen receptor T-cell (CAR-T) therapies have dramatically improved the outcomes of relapsed/refractory B-cell malignancies, recipients suffer from severe humoral immunodeficiencies. Furthermore, patients with coronavirus disease 2019 (COVID-19) have a poor prognosis, as noted in several case reports of recipients who had COVID-19 before the infusion. We report the case of a 70-year-old woman who developed COVID-19 immediately before CAR-T therapy for high-grade B-cell lymphoma. She received Tixagevimab-Cilgavimab chemotherapy and radiation therapy but never achieved remission. She was transferred to our hospital for CAR-T therapy, but developed COVID-19. Her symptoms were mild and she was treated with long-term molnupiravir. On day 28 post-infection, lymphodepleting chemotherapy was restarted after a negative polymerase chain reaction (PCR) test was confirmed. The patient did not experience recurrence of COVID-19 symptoms or severe cytokine release syndrome. Based on the analysis and comparison of the previous reports with this case, we believe that CAR-T therapy should be postponed until a negative PCR test is confirmed. In addition, Tixagevimab-Cilgavimab and long term direct-acting antiviral agent treatment can be effective prophylaxis for severe COVID-19 and shortening the duration of infection.
Key words
Full text:
1
Database:
MEDLINE
Main subject:
Lymphoma, Large B-Cell, Diffuse
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Hepatitis C, Chronic
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Receptors, Chimeric Antigen
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COVID-19
Limits:
Aged
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Female
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Humans
Language:
En
Year:
2024
Type:
Article