Case Report: Dual Inhibition of HDAC and BTK for Diffuse Large B-Cell Lymphoma After Failure to CD19-Targeted CAR-T Therapy.

Case Report: Dual Inhibition of HDAC and BTK for Diffuse Large B-Cell Lymphoma After Failure to CD19-Targeted CAR-T Therapy.
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病例报告:CD 19靶向CAR-T治疗失败后HDAC和BTK双重抑制弥漫性大B细胞淋巴瘤。

DOI:
10.3389/fimmu.2022.894787
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发表时间:
2022
影响因子:
7.3
通讯作者:
Yuan, Xianggui
Yuan, Xianggui
中科院分区:
医学2区
文献类型:
--
作者:
Zhu, Weiguo;Tao, Shi;Miao, Wenchun;Liu, Hui;Yuan, Xianggui

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复发性/难治性(R/R)弥漫性大B细胞淋巴瘤(DLBCL)患者未能接受靶向CD 19嵌合抗原受体T细胞(CAR-T)治疗是一个新出现的临床问题。对于这些患者的治疗没有共识,治疗仍然是经验性的。我们报告了一例老年R/R DLBCL患者,该患者患有TP 53突变,并在CAR T细胞治疗初始应答后12个月复发。该患者对GDP方案的补救化疗无反应,并且不能耐受任何侵袭性化疗。此后,患者接受西达米特和扎奴替尼治疗。经过两个月的治疗,患者获得了持续的完全缓解。在末次随访时,患者在CAR-T输注后22个月和联合治疗开始后10个月保持放射学CR。我们报告了第一例成功的HDAC和BTK双重抑制治疗CAR-T细胞治疗失败后的R/R DLBCL的病例,这为未来开辟了新的治疗可能性。
Failure to CD19-targeted chimeric antigen receptor T-cell (CAR-T) therapy for patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL), is an emerging clinical problem. There is no consensus on the treatment for these patients and treatment remains empirical. We reported a case of an elderly R/R DLBCL patient who had TP53 mutation and relapsed 12 months after initial response to CAR T-cell therapy. The patient did not respond to salvage chemotherapy with the GDP regimen and could not tolerate any aggressive chemotherapy. Thereafter, the patient was given chidamide and zanubrutinib. After two months of treatment, the patient achieved sustained complete remission. At the last follow-up, the patient remains in radiographic CR 22 months after CAR-T infusion and 10 months after the initiation of the combination treatment. We report the first successful case of dual inhibition of HDAC and BTK for the treatment of R/R DLBCL after failure to CAR-T cell therapy, which opens a new therapeutic possibility for the future.
对复发或难治性淋巴瘤中的组蛋白脱乙酰基酶抑制剂的2阶段研究。
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