Incidentally cured psoriasis in a patient with refractory/relapsed diffuse large B-cell lymphoma receiving CD19 CAR-T cell therapy: a case report

Front Immunol. 2024 Oct 24:15:1418768. doi: 10.3389/fimmu.2024.1418768. eCollection 2024.

Abstract

Chimeric antigen receptor T (CAR-T) cell therapy is a new treatment for cancers, but reports on curing immune-related skin diseases are limited. We report a case of successful CAR-T-cell therapy in a patient with refractory/relapsed diffuse large B-cell lymphoma (R/R DLBCL) who was incidentally cured of chronic generalized plaque psoriasis. The patient, a 65-year-old male who had a known history of psoriasis for 45 years, did not receive immunotherapy for psoriasis during this period. Imaging, molecular biology and immunology diagnostics confirmed DLBCL. After several weeks of standard-dose R-CHOP chemotherapy, the patient achieved partial remission, but according to CT, the patient relapsed, and there was no significant improvement in her psoriasis symptoms. Subsequently, the patient was enrolled in the CD19 CAR-T-cell therapy group. Four weeks after CAR-T-cell infusion, the patient's abdominal pain disappeared, and there was a significant improvement in overall skin lesions. One year later, follow-up results indicated complete remission of R/R DLBCL (confirmed by PET-CT), with only minimal residual psoriatic skin lesions limited to the patient's neck. The results of using CAR-T-cell therapy to achieve an incidental cure for psoriasis highlight the potential for exploring cell-based therapies for complex autoinflammatory skin diseases.

Keywords: CD19 CAR-T; case report; cell therapy; psoriasis; refractory/relapsed diffuse large B cell lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antigens, CD19* / immunology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Humans
  • Immunotherapy, Adoptive* / adverse effects
  • Immunotherapy, Adoptive* / methods
  • Lymphoma, Large B-Cell, Diffuse* / immunology
  • Lymphoma, Large B-Cell, Diffuse* / therapy
  • Male
  • Prednisone / therapeutic use
  • Psoriasis* / immunology
  • Psoriasis* / therapy
  • Receptors, Chimeric Antigen / immunology
  • Rituximab
  • Treatment Outcome
  • Vincristine / therapeutic use

Substances

  • Antigens, CD19
  • Doxorubicin
  • Receptors, Chimeric Antigen
  • Cyclophosphamide
  • Vincristine
  • Prednisone
  • R-CHOP protocol
  • Rituximab

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study’s publication was supported by the Medical Science and Technique Foundation of Henan Province (No. LHGJ20220937), the Medical and Health Project of the Luoyang Science and Technology Program (No. 1910014A) and the Traditional Chinese Medicine Culture and Management Project of Henan Province (No. TCM2021004).