Successful CAR-T cell therapy in a refractory MCL patient with bacterial, fungal and COVID-19 infection: a case report
BackgroundThe COVID-19 pandemic has had a significant impact on the management and care of onco-hematological patients, particularly those with lymphoproliferative disorders who are at higher risk for COVID-19 associated bacterial and fungal superinfections.Case presentationWe present the successful...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Transplantation |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/frtra.2023.1238494/full |
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| author | Vera Radici Cinzia Giagulli Eugenia Accorsi Buttini Mirko Farina Nicola Polverelli Duilio Brugnoni Marco Chiarini Anna Galvagni Camillo Almici Emilio Ferrari Andrea Bianchetti Stefania Masneri Alessandro Leoni Alessandro Leoni Federica Re Federica Re Simona Bernardi Simona Bernardi Michele Malagola Alessandro Re Arnaldo Caruso Domenico Russo |
| author_facet | Vera Radici Cinzia Giagulli Eugenia Accorsi Buttini Mirko Farina Nicola Polverelli Duilio Brugnoni Marco Chiarini Anna Galvagni Camillo Almici Emilio Ferrari Andrea Bianchetti Stefania Masneri Alessandro Leoni Alessandro Leoni Federica Re Federica Re Simona Bernardi Simona Bernardi Michele Malagola Alessandro Re Arnaldo Caruso Domenico Russo |
| author_sort | Vera Radici |
| collection | DOAJ |
| description | BackgroundThe COVID-19 pandemic has had a significant impact on the management and care of onco-hematological patients, particularly those with lymphoproliferative disorders who are at higher risk for COVID-19 associated bacterial and fungal superinfections.Case presentationWe present the successful treatment of a 44-year-old male patient with refractory mantle cell lymphoma treated with chimeric antigen receptor T (CAR-T) cell therapy, despite concurrent COVID-19 infection. The patient developed grade II cytokine release syndrome, requiring admission to the intensive care unit. The CAR-T cells expanded effectively, and the patient achieved complete metabolic remission. During the treatment course, the patient experienced complications including COVID-19-associated pulmonary aspergillosis and a co-infection with Stenotrophomonas maltophilia and the SARS-CoV-2 omicron variant. Prompt antifungal and antibacterial therapy, along with appropriate COVID-19 treatment, led to the resolution of these infections. Dexamethasone was also administered to reduce inflammation and aid hematologic recovery. Despite the presence of multiple infections, the patient achieved complete remission of lymphoma, highlighting the effectiveness of CAR-T cell therapy in this high-risk patient.ConclusionDespite the challenges posed by concurrent infections, the decision to proceed with CAR-T cell therapy in this patient proved to be successful, resulting in complete remission of lymphoma. Early initiation of supportive therapies and the use of dexamethasone contributed to the resolution of complications. This case underscores the importance of individualized decision-making and the potential benefits of CAR-T cell therapy in similar high-risk patients. |
| first_indexed | 2024-03-11T23:44:23Z |
| format | Article |
| id | doaj.art-d0165fccbf9a414894d27b2ef0caf53b |
| institution | Directory Open Access Journal |
| issn | 2813-2440 |
| language | English |
| last_indexed | 2024-03-11T23:44:23Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Transplantation |
| spelling | doaj.art-d0165fccbf9a414894d27b2ef0caf53b2023-09-19T15:03:43ZengFrontiers Media S.A.Frontiers in Transplantation2813-24402023-09-01210.3389/frtra.2023.12384941238494Successful CAR-T cell therapy in a refractory MCL patient with bacterial, fungal and COVID-19 infection: a case reportVera Radici0Cinzia Giagulli1Eugenia Accorsi Buttini2Mirko Farina3Nicola Polverelli4Duilio Brugnoni5Marco Chiarini6Anna Galvagni7Camillo Almici8Emilio Ferrari9Andrea Bianchetti10Stefania Masneri11Alessandro Leoni12Alessandro Leoni13Federica Re14Federica Re15Simona Bernardi16Simona Bernardi17Michele Malagola18Alessandro Re19Arnaldo Caruso20Domenico Russo21Unit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Science, University of Brescia, ASST Spedali Civili di Brescia, Brescia, ItalySection of Microbiology, Department of Molecular and Translational Medicine, School of Medicine, University of Brescia, Brescia, ItalyUnit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Science, University of Brescia, ASST Spedali Civili di Brescia, Brescia, ItalyUnit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Science, University of Brescia, ASST Spedali Civili di Brescia, Brescia, ItalyUnit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Science, University of Brescia, ASST Spedali Civili di Brescia, Brescia, ItalySection of Microbiology, Department of Molecular and Translational Medicine, School of Medicine, University of Brescia, Brescia, ItalyFlow Cytometry Unit, Clinical Chemistry Laboratory, ASST Spedali Civili di Brescia, Brescia, ItalyFlow Cytometry Unit, Clinical Chemistry Laboratory, ASST Spedali Civili di Brescia, Brescia, ItalyStem Cell Laboratory, Servizio di Immunoematologia e Medicina Trasfusionale, ASST Spedali Civili di Brescia, Brescia, ItalyStem Cell Laboratory, Servizio di Immunoematologia e Medicina Trasfusionale, ASST Spedali Civili di Brescia, Brescia, ItalyStem Cell Laboratory, Servizio di Immunoematologia e Medicina Trasfusionale, ASST Spedali Civili di Brescia, Brescia, ItalyStem Cell Laboratory, Servizio di Immunoematologia e Medicina Trasfusionale, ASST Spedali Civili di Brescia, Brescia, ItalyUnit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Science, University of Brescia, ASST Spedali Civili di Brescia, Brescia, ItalyCREA Laboratory (Centro di Ricerca Emato-Oncologica AIL), ASST Spedali Civili di Brescia, Brescia, ItalyUnit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Science, University of Brescia, ASST Spedali Civili di Brescia, Brescia, ItalyCREA Laboratory (Centro di Ricerca Emato-Oncologica AIL), ASST Spedali Civili di Brescia, Brescia, ItalyUnit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Science, University of Brescia, ASST Spedali Civili di Brescia, Brescia, ItalyCREA Laboratory (Centro di Ricerca Emato-Oncologica AIL), ASST Spedali Civili di Brescia, Brescia, ItalyUnit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Science, University of Brescia, ASST Spedali Civili di Brescia, Brescia, ItalyHematology Unit, ASST Spedali Civili di Brescia, Brescia, ItalySection of Microbiology, Department of Molecular and Translational Medicine, School of Medicine, University of Brescia, Brescia, ItalyUnit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Science, University of Brescia, ASST Spedali Civili di Brescia, Brescia, ItalyBackgroundThe COVID-19 pandemic has had a significant impact on the management and care of onco-hematological patients, particularly those with lymphoproliferative disorders who are at higher risk for COVID-19 associated bacterial and fungal superinfections.Case presentationWe present the successful treatment of a 44-year-old male patient with refractory mantle cell lymphoma treated with chimeric antigen receptor T (CAR-T) cell therapy, despite concurrent COVID-19 infection. The patient developed grade II cytokine release syndrome, requiring admission to the intensive care unit. The CAR-T cells expanded effectively, and the patient achieved complete metabolic remission. During the treatment course, the patient experienced complications including COVID-19-associated pulmonary aspergillosis and a co-infection with Stenotrophomonas maltophilia and the SARS-CoV-2 omicron variant. Prompt antifungal and antibacterial therapy, along with appropriate COVID-19 treatment, led to the resolution of these infections. Dexamethasone was also administered to reduce inflammation and aid hematologic recovery. Despite the presence of multiple infections, the patient achieved complete remission of lymphoma, highlighting the effectiveness of CAR-T cell therapy in this high-risk patient.ConclusionDespite the challenges posed by concurrent infections, the decision to proceed with CAR-T cell therapy in this patient proved to be successful, resulting in complete remission of lymphoma. Early initiation of supportive therapies and the use of dexamethasone contributed to the resolution of complications. This case underscores the importance of individualized decision-making and the potential benefits of CAR-T cell therapy in similar high-risk patients.https://www.frontiersin.org/articles/10.3389/frtra.2023.1238494/fullCOVID-19infectionCAR-T celllymphomamantle cell lymphoma (MCL) |
| spellingShingle | Vera Radici Cinzia Giagulli Eugenia Accorsi Buttini Mirko Farina Nicola Polverelli Duilio Brugnoni Marco Chiarini Anna Galvagni Camillo Almici Emilio Ferrari Andrea Bianchetti Stefania Masneri Alessandro Leoni Alessandro Leoni Federica Re Federica Re Simona Bernardi Simona Bernardi Michele Malagola Alessandro Re Arnaldo Caruso Domenico Russo Successful CAR-T cell therapy in a refractory MCL patient with bacterial, fungal and COVID-19 infection: a case report Frontiers in Transplantation COVID-19 infection CAR-T cell lymphoma mantle cell lymphoma (MCL) |
| title | Successful CAR-T cell therapy in a refractory MCL patient with bacterial, fungal and COVID-19 infection: a case report |
| title_full | Successful CAR-T cell therapy in a refractory MCL patient with bacterial, fungal and COVID-19 infection: a case report |
| title_fullStr | Successful CAR-T cell therapy in a refractory MCL patient with bacterial, fungal and COVID-19 infection: a case report |
| title_full_unstemmed | Successful CAR-T cell therapy in a refractory MCL patient with bacterial, fungal and COVID-19 infection: a case report |
| title_short | Successful CAR-T cell therapy in a refractory MCL patient with bacterial, fungal and COVID-19 infection: a case report |
| title_sort | successful car t cell therapy in a refractory mcl patient with bacterial fungal and covid 19 infection a case report |
| topic | COVID-19 infection CAR-T cell lymphoma mantle cell lymphoma (MCL) |
| url | https://www.frontiersin.org/articles/10.3389/frtra.2023.1238494/full |
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