Recently, under the leadership and guidance of Professor Xu Kailin, the leader of the Department of Hematology of the Xu Hospital Affiliated Hospital, Dr. Cao Jiang and the Jiangsu Cancer Biotherapy Collaborative Innovation Center (Jiangsu Institute of Cancer Biotherapy) and Department of Radiology, Xu Hospital Affiliated Hospital Shanghai Jiaotong University, University of Texas Southwestern Medical Center, and Shanghai Longyao Biotechnology Co., Ltd., a multi-target, multi-type CAR-T cell sequential therapy for a patient with advanced malignant lymphoma. One month after returning the cells, the patient's multiple masses disappeared, and the relevant indicators returned to normal, indicating successful treatment. It is reported that this is the first multi-target, multi-type CAR-T cell sequential therapy to achieve complete remission of advanced lymphoma patients.
Patient Zhou Hua (pseudonym), female, 62 years old, was diagnosed as diffuse large B-cell lymphoma (origin of germinal center, stage IV) by pathological examination in April 2016. The chromosome showed a complex karyotype. Multiple chemotherapy has been given, and the disease control is not ideal. PET-CT shows bilateral parotid gland, nasopharynx, oropharynx, bilateral submandibular, axillary, sternocleidomastoid inner edge, bilateral posterior cervical triangle, Upper supraclavicular region, subcutaneous scapular subcutaneous, bilateral axillary fossa, mediastinum, bilateral hilar, right palpitations, bilateral sacral angles, interhepatic and gastric, peripancreatic, mesenteric root, abdominal aorta, right In the mesenteric area, bilateral periorbital vessels, bilateral inguinal regions, and periorbital mesangial area, multiple lymph nodes were enlarged, and glucose metabolism was significantly increased, suggesting that the tumor was extensively invaded and the prognosis was extremely poor.
The patient's conventional treatment has no obvious effect, even the prognosis of salvage autologous hematopoietic stem cell transplantation is very poor. The patient's family sent the last line of hope to CAR-T cell therapy. In August 2016, patients were infused with IL-7+IL-15 co-cultured CD19 CAR-T cells, and the mass only shortened briefly and then swollen again. In September 2016, she switched to IL-2 cultured CD19 CAR-T cells for infusion. There was no significant change in the patient's mass. At this time, the patient and her family had fallen into despair and were ready to give up treatment. After repeated discussions, the medical team decided to try CD20 CAR-T treatment in combination with international frontier theory. Half a month after the infusion of CAR-T cells in November 2016, the patient's enlarged lymph nodes completely resolved and the side effects were mild during the treatment. At present, the cells have been returned for one month. The review of PET-CT showed that multiple masses had disappeared and the patients had achieved complete remission. Dr. Cao Jiang believes that the treatment experience of this patient suggests that sequential or combined multi-target CAR-T cell therapy is expected to bring more gospel to patients with advanced lymphoma.
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