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Extramedullary relapse of acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation treated by CAR T-cell therapy: a case report

Authors Wang D, Shi R, Wang Q, Li J

Received 2 February 2018

Accepted for publication 25 June 2018

Published 28 September 2018 Volume 2018:11 Pages 6327—6332

DOI https://doi.org/10.2147/OTT.S164430

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Samir Farghaly


Dongmei Wang,1 Rui Shi,1 Qinglong Wang,2 Jianqiang Li2

1Department of Hematology, Harrison International Peace Hospital, Hengshui, Hebei 053000, People’s Republic of China; 2Hebei Senlangbio Technology Co., Ltd, Shijiazhuang, Hebei 050000, People’s Republic of China

Abstract: Philadelphia chromosome-positive (Ph-positive) acute leukemia (ALL) accounts for around one quarter of adult cases of ALL and is usually associated with poor prognosis. The patients still encounter a high rate of relapse even after they receive hematopoietic stem cell transplantation (HSCT). HSCT is considered the established therapy and best option for many malignant ALL cases, however, disease relapse remains the main reason of failure. In recent years, chimeric antigen receptor (CAR) T-cell therapy has become a promising treatment for patients with advanced blood cancers. Here, we report a rare case of a Ph-positive ALL patient with extramedullary relapse in her cervix after receiving allogeneic HSCT. Given the unsatisfactory response to chemotherapy, tyrosine kinase inhibitor (TKI) treatment, and HSCT transplantation, she had received CD19+ CAR T-cell therapy 8 months earlier. The following ultrasound check indicated that her cervix relapse went through significant remission with almost undetectable tumor mass. This case strongly supports the efficacy of CAR T-cell therapy on adult ALL with extramedullary relapse.

Keywords:
acute lymphoblastic leukemia, allogeneic hematopoietic stem cell transplantation, CAR T-cell therapy, cervix relapse

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