Lenalidomide Treatment of Isolated Central Nervous System Relapse in Acute Lymphoblastic Leukemia after Hematopoietic Stem Cell Transplantation and Chimeric Antigen Receptor T-Cell Therapy.
Acta Haematol
; 147(5): 592-597, 2024.
Article
en En
| MEDLINE
| ID: mdl-38359803
ABSTRACT
INTRODUCTION:
Hematopoietic stem cell transplantation (HSCT) and chimeric antigen receptor T (CAR-T) cell are effective treatments for acute lymphoblastic leukemia (ALL). Various forms of intra- and extramedullary relapses have been reported after HSCT and CAR-T-cell therapy for ALL; however, no reports have investigated isolated central nervous system (CNS) relapse after HSCT and CAR-T-cell therapy. Hence, no clinical treatment has been established for such rare patients. CASE PRESENTATION An 18-year-old male patient with B-cell ALL suffered from isolated CNS relapse after HSCT and CAR-T-cell therapy. Conventional systemic intravenous and intrathecal chemotherapies were ineffective and intolerable. A unique immunosuppressive microenvironment of decreasing NK cell percentage and increasing IL-8 concentration and CAR-T-cell exhaustion had been illustrated in the cerebrospinal fluid. Finally, the patient received immunomodulatory therapy with lenalidomide and obtained complete remission.CONCLUSION:
Lenalidomide might be a therapeutic strategy for isolated CNS relapse after HSCT and CAR-T-cell therapy.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Inmunoterapia Adoptiva
/
Trasplante de Células Madre Hematopoyéticas
/
Leucemia-Linfoma Linfoblástico de Células Precursoras
/
Lenalidomida
Límite:
Adolescent
/
Humans
/
Male
Idioma:
En
Año:
2024
Tipo del documento:
Article