A 57-year-old patient with high-risk factors (such as pleural effusion and high tumor burden) and relapsed or refractory mantle cell lymphoma (r/r MCL) had previously failed seven lines of treatment, including multiple systemic chemotherapies, autologous stem cell transplantation, and BTK inhibitors (ibrutinib). After receiving a single dose of Carteyva infusion, the patient achieved a long-term and sustained complete remission (CR).
This patient had a history of sinusitis for over 10 years and was diagnosed with Ann-Arbor Stage III S mantle cell lymphoma in January 2013. After seven rounds of treatment, the disease continued to progress.
In March 2021, the patient was enrolled in a clinical study at Peking University Cancer Hospital for “CAR T-cell Therapy in Relapsed/Refractory Mantle Cell Lymphoma.” During screening, CT scans revealed enlarged lymph nodes in multiple regions (including bilateral neck, chest, abdomen, and groin), affecting the pleura, liver, bilateral kidneys, and right pleura, accompanied by pleural effusion and ascites. Baseline FDG-PET/CT scans showed nodules in several areas (including the sternum, right pleural region, peritoneum, and bilateral kidneys), along with splenomegaly and increased metabolic lesions. After undergoing lymphocyte-depleting chemotherapy (cyclophosphamide + fludarabine) followed by Relma-cel infusion, the results were as follows:
1. No Residual Disease Detected: By day 15 of treatment, a bone marrow smear assessment showed no residual disease.
2. FDG-PET/CT Results: A follow-up FDG-PET/CT scan on day 29 showed no significant disease progression compared to baseline, and both ascites and pleural effusion were reduced.
3. Lymph Node Reduction: A CT scan on day 29 showed reduced lymph nodes in multiple areas (including neck, chest, abdomen, groin, and iliac) with the longest diameter decreasing from 112 mm (pre-treatment) to 81 mm (post-treatment).
4. Complete Remission: One month after CAR-T infusion, overall assessments indicated a sustained complete metabolic remission. CT scans confirmed that the patient achieved complete remission (CR), which was maintained for two years of follow-up.
In summary, the Carteyva CAR-T cell therapy successfully reversed the high-risk condition of this mantle cell lymphoma patient, leading to a sustained complete remission lasting over two years!
