Indolent CD4+ CAR T-Cell Lymphoma after Cilta-cel CAR T-Cell Therapy

Metin Ozdemirli; Thomas M Loughney; Emre Deniz; Joeffrey J Chahine; Maher Albitar; Stefania Pittaluga; Sam Sadigh; Philippe Armand; Aykut Uren; Kenneth C Anderson

doi:10.1056/NEJMoa2401530

Indolent CD4+ CAR T-Cell Lymphoma after Cilta-cel CAR T-Cell Therapy

N Engl J Med. 2024 Jun 13;390(22):2074-2082. doi: 10.1056/NEJMoa2401530.

Affiliation

¹ From the Departments of Pathology (M.O., J.J.C.) and Gastroenterology (T.M.L.), MedStar Georgetown University Hospital, and Lombardi Comprehensive Cancer Center, Georgetown University Medical Center (E.D., A.U.) - both in Washington, DC; the Genomic Testing Cooperative, Irvine, CA (M.A.); the National Institutes of Health, Bethesda, MD (S.P.); and Brigham and Women's Hospital (S.S.), the Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute (K.C.A.), and Harvard Medical School (P.A.) - all in Boston.

PMID: 38865661
DOI: 10.1056/NEJMoa2401530

Abstract

Indolent CD4+ cytotoxic chimeric antigen receptor (CAR) T-cell lymphoma involving the small intestine was diagnosed in a patient who had previously received ciltacabtagene autoleucel (cilta-cel) CAR T-cell therapy for treatment of myeloma. Targeted messenger RNA sequencing revealed the presence of CAR gene product in tumor cells. Whole-genome sequencing of samples of tumor and peripheral blood identified a single lentiviral insertion site within the second intron of the SSU72 gene. In addition, numerous genetic alterations that may have contributed to malignant transformation were identified in the tumor sample. (Funded by MedStar Georgetown University Hospital.).

Publication types

Case Reports

MeSH terms

Antineoplastic Agents, Immunological* / adverse effects
Antineoplastic Agents, Immunological* / therapeutic use
Biological Products / administration & dosage
Biological Products / therapeutic use
CD4-Positive T-Lymphocytes* / immunology
Humans
Immunotherapy, Adoptive* / adverse effects
Immunotherapy, Adoptive* / methods
Lymphoma, T-Cell* / etiology
Lymphoma, T-Cell* / genetics
Lymphoma, T-Cell* / immunology
Lymphoma, T-Cell* / therapy
Male
Middle Aged
Multiple Myeloma / genetics
Multiple Myeloma / immunology
Multiple Myeloma / therapy
Receptors, Antigen, T-Cell / genetics
Receptors, Antigen, T-Cell / therapeutic use
Receptors, Chimeric Antigen* / immunology
Receptors, Chimeric Antigen* / therapeutic use

Substances

axicabtagene ciloleucel
Biological Products
Receptors, Antigen, T-Cell
Receptors, Chimeric Antigen
Antineoplastic Agents, Immunological