Concurrent remission of lymphoma and Sjögren’s disease following anti-CD19 chimeric antigen receptor-T cell therapy for diffuse large B-cell lymphoma: a case report

• Published in: Frontiers in immunology Vol. 14; p. 1298815
• Main Authors: Sheng, Lingshuang, Zhang, Yilun, Song, Qi, Jiang, Xufeng, Cao, Weiguo, Li, Lei, Yi, Hongmei, Weng, Xiangqin, Chen, Sheng, Wang, Zhongmin, Wu, Wen, Wang, Li, Zhao, Weili, Yan, Zixun
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 19.12.2023
• Subjects: Aged; Antigens, CD19; autoimmune diseases; CAR-T cell therapy; Cell- and Tissue-Based Therapy; chimeric T cell receptors; Female; Humans; Immunology; immunotherapy; Immunotherapy, Adoptive; Lymphoma, Large B-Cell, Diffuse - therapy; Receptors, Chimeric Antigen; Sjogren's Syndrome - complications; Sjogren's Syndrome - therapy; Sjögren’s disease; autoimmune diseases; chimeric T cell receptors; Sjögren’s disease; CAR-T cell therapy; immunotherapy
• ISSN: 1664-3224; 1664-3224
• DOI: 10.3389/fimmu.2023.1298815

Anti-CD19 chimeric antigen receptor (CAR)-T cells not only target CD19-positive malignant lymphoma cells but also normal B cells. The utility of CAR-T cell therapy has been reported in rheumatoid arthritis and systemic lupus erythematosus; however, its use in Sjögren’s disease (SjD) remains unknown. In this study, we describe the case of a 76-year-old woman with active SjD for 10 years who was diagnosed with diffuse large B-cell lymphoma. After receiving anti-CD19 CAR-T cell therapy, she achieved complete remission (CR) on day 28. Since the onset of her 10-year history with SjD, she was negative for antinuclear antibodies and anti-Ro-52 for the first time on day 90 after CAR-T cell therapy. Six months after CAR-T cell therapy, the CR status was maintained, serum cytokine levels returned to their normal levels, and dry mouth symptoms improved. The EULAR Sjögren’s Syndrome Disease Activity Index score decreased from 5 to 2, indicating a partial remission of SjD activity compared with that before CAR-T cell treatment. In the early stage of treatment, she presented with grade 2 cytokine release syndrome and grade 1 neurotoxicity, which were completely controlled after an active intervention. This case highlights the potential application of CAR-T cells in treating autoimmune diseases, such as SjD.