期刊
BRITISH JOURNAL OF HAEMATOLOGY
卷 171, 期 2, 页码 205-209出版社
WILEY-BLACKWELL
DOI: 10.1111/bjh.13562
关键词
leukaemia; chronic lymphocytic leukaemia; plasmablastic; lymphoma; chimeric antigen receptor T cells
类别
资金
- Alliance for Cancer Gene Therapy (ACGT) Foundation Grant
- National Institutes of Health, National Cancer Institute [R01CA120409]
- Novartis Research Grant
- James P. Wilmot Cancer Research Fellowship
A patient with relapsed and refractory chronic lymphocytic leukaemia with Richter transformation was treated with chimeric antigen receptor (CAR)-modified T cells targeted for CD19 but later relapsed with a clonally related plasmablastic lymphoma. The loss of most routine markers of pre-plasma cell or B lymphoid differentiation (including CD19) highlights the ability of such mature lymphomas to evade lineage-specific targeted immunotherapy by differentiating along pathways comparable to their normal cellular counterparts. Molecular genetic evaluation demonstrated multiple independent lines of CD19-negative disease that eventually evolved in this single patient. Such plasticity represents potential challenges for antigen-directed CAR-T cell therapy, while serving as a testament to the selective pressure exerted by these engineered T cells over time.
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