Long-term remission in a patient with relapsed Richter's transformation treated with CD19-directed chimeric antigen-receptor T-cells after allogeneic stem cell transplantation

Eur J Haematol. 2024 Jun;112(6):984-987. doi: 10.1111/ejh.14182. Epub 2024 Feb 5.

Abstract

Patients with Richter's transformation of chronic lymphocytic leukemia (CLL) to diffuse large B-cell lymphoma (DLBCL-RT) face a dismal prognosis. A 51-year-old female patient diagnosed with CLL with deletion (17p) in 2009. CLL treatment included chemoimmunotherapy and targeted substances. DLBCL-RT was diagnosed in November 2016. After receiving an allogeneic hematopoietic stem cell transplantation, she relapsed in September 2019 and tisagenlecleucel was infused in December 2019. Cytokine release syndrome grade 2 was treated with two doses of tocilizumab and the patient was started on 140 mg ibrutinib in February 2020. Our patient remains in remission up to 4 years after CAR T-cell treatment.

Keywords: CAR T cell therapy; Richter's transformation.

Publication types

  • Case Reports

MeSH terms

  • Antigens, CD19* / immunology
  • Combined Modality Therapy
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunotherapy, Adoptive* / adverse effects
  • Immunotherapy, Adoptive* / methods
  • Leukemia, Lymphocytic, Chronic, B-Cell* / diagnosis
  • Leukemia, Lymphocytic, Chronic, B-Cell* / therapy
  • Lymphoma, Large B-Cell, Diffuse* / diagnosis
  • Lymphoma, Large B-Cell, Diffuse* / therapy
  • Middle Aged
  • Piperidines / therapeutic use
  • Receptors, Antigen, T-Cell / genetics
  • Receptors, Chimeric Antigen
  • Recurrence
  • Remission Induction*
  • Transplantation, Homologous*
  • Treatment Outcome

Substances

  • Antigens, CD19
  • Receptors, Chimeric Antigen
  • Piperidines
  • Receptors, Antigen, T-Cell