Severe dyspnea caused by rapid enlargement of cervical lymph node in a relapsed/refractory B-cell lymphoma patient following chimeric antigen receptor T-cell therapy

Aiyun Jin; Jingjing Feng; Zhudan Wang; Li Jiang; Yongxian Hu; Kui Zhao; He Huang

doi:10.1038/s41409-018-0412-1

Severe dyspnea caused by rapid enlargement of cervical lymph node in a relapsed/refractory B-cell lymphoma patient following chimeric antigen receptor T-cell therapy

Bone Marrow Transplant. 2019 Jul;54(7):969-972. doi: 10.1038/s41409-018-0412-1. Epub 2018 Dec 18.

Authors

Aiyun Jin^{1

2

3}, Jingjing Feng^{1

2

3}, Zhudan Wang^{1

2

3}, Li Jiang^{1

2

3}, Yongxian Hu^{1

2

3}, Kui Zhao⁴, He Huang^{5

6

7}

Affiliations

¹ Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
² Institute of Hematology, Zhejiang University, Hangzhou, China.
³ Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China.
⁴ PET/CT Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
⁵ Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. huanghe@zju.edu.cn.
⁶ Institute of Hematology, Zhejiang University, Hangzhou, China. huanghe@zju.edu.cn.
⁷ Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China. huanghe@zju.edu.cn.

PMID: 30563981
DOI: 10.1038/s41409-018-0412-1

Abstract

Adoptive transfer of T cells modified to express chimeric antigen receptors (CARs) targeting CD19 (CART19s) has demonstrated impressive results in treating B-cell malignancies. Although CART19-induced complications have been gradually recognized, local cytokine-release syndrome (CRS) at particular parts of the body has not been extensively studied. In this paper, we firstly present a successfully treated case of severe dyspnea caused by the rapid enlargement of cervical lymph node following CART19 therapy in a relapsed/refractory DLBCL patient, with emphasis on the recognition, workup, and treatment. This report reminds for a careful evaluation and observation of the pre-existing mass, which could enlarge rapidly again as a result of CRS and be life threatening, in the CART therapy.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Cell- and Tissue-Based Therapy / methods*
Dyspnea / etiology*
Humans
Lymph Nodes / pathology*
Lymphoma, Large B-Cell, Diffuse / complications*
Lymphoma, Large B-Cell, Diffuse / therapy
Male
Middle Aged
Receptors, Chimeric Antigen / therapeutic use*

Substances

Receptors, Chimeric Antigen