Case report: Sandwich therapy of CAR-T combined with ASCT: Sequential CAR-T cell therapy with ASCT after remission with CAR-T therapy caused long-term survival in a patient with relapsed/refractory Burkitt's lymphoma with TP53 mutations

• Published in: Frontiers in immunology 2023-03, Vol.14, p.1127868
• Main Authors: Zhang, Qi, Zhu, Xiaojian, Liu, Bo, Zhang, Yicheng, Xiao, Yi
• Format: Article
• Language: English
• Subjects: ASCT; Burkitt Lymphoma - genetics; Burkitt Lymphoma - therapy; Burkitt’s lymphoma; CAR-T; Cell- and Tissue-Based Therapy; Humans; Immunology; Mutation; Neoplasm Recurrence, Local; Receptors, Chimeric Antigen - genetics; relapsed/refractory; TP53 mutations; Tumor Suppressor Protein p53 - genetics
• ISSN: 1664-3224; 1664-3224
• DOI: 10.3389/fimmu.2023.1127868

Burkitt's lymphoma (BL) with TP53 mutation often has poor outcome after standard chemoimmunotherapy. Adoptive chimeric antigen receptor (CAR)-T cell therapy may be a new paradigm for treating refractory/relapsed (r/r) BL, but its therapeutic effects remain inconclusive. Here, we report a patient with r/r BL who failed to achieve complete remission (CR) and progressed rapidly after multiple protocol chemotherapy. The patient achieved CR with CAR19 and CAR22 T-cell cocktail therapy and obtained long-term disease-free survival after autologous hematopoietic stem cells (ASCT) and subsequential CAR19 and CAR22 T-cell cocktail therapy. The clinical evolution and genetic features of this case may provide some guidance for CAR-T therapy in overcoming relapses associated with TP53 gene mutations.