CD19-Directed CAR T-Cells in a Patient With Refractory MOGAD: Clinical and Immunologic Follow-Up for 1 Year.
Neurol Neuroimmunol Neuroinflamm
; 11(5): e200292, 2024 Sep.
Article
en En
| MEDLINE
| ID: mdl-39106426
ABSTRACT
OBJECTIVES:
In MOG antibody-associated disease (MOGAD), relapse prevention and the treatment approach to refractory symptoms are unknown. We report a patient with refractory MOGAD treated with CD19-directed CAR T-cells.METHODS:
CD19-directed CAR T-cells (ARI-0001) were produced in-house by lentiviral transduction of autologous fresh leukapheresis and infused after a conventional lymphodepleting regimen.RESULTS:
A 18-year-old man developed 2 episodes of myelitis associated with serum MOG-IgG, which were followed by 6 episodes of left optic neuritis (ON) and sustained the presence of MOG-IgG over 6 years despite multiple immunotherapies. After the sixth episode of ON, accompanied by severe residual visual deficits, CAR T-cell treatment was provided without complications. Follow-up of cell counts showed complete depletion of CD19+ B cells at day +7; reconstituted B cells at day +141 showing a naïve B-cell phenotype, and low or absent memory B cells and plasmablasts for 1 year. MOG-IgG titers have remained undetectable since CAR T-cell infusion. The patient had an early episode of left ON at day +29, when MOG-IgG was already negative, and since then he has remained free of relapses without immunotherapy for 1 year.DISCUSSION:
This clinical case shows that CD19-directed CAR T-cell therapy is well-tolerated and is a potential treatment for patients with refractory MOGAD. CLASSIFICATION OF EVIDENCE This provides Class IV evidence. It is a single observational study without controls.
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Banco de datos:
MEDLINE
Asunto principal:
Inmunoterapia Adoptiva
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Antígenos CD19
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Glicoproteína Mielina-Oligodendrócito
Límite:
Adolescent
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Humans
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Male
Idioma:
En
Año:
2024
Tipo del documento:
Article