Intrathecal CAR-NK cells infusion for isolated CNS relapse after allogeneic stem cell transplantation: case report.
Jing YuanFuxu WangHanyun RenPublished in: Stem cell research & therapy (2023)
A 24-year-old man with central nervous system (CNS) involvement of T-cell lineage acute lymphoblastic leukemia received sibling allogeneic stem cell transplantation (allo-SCT). He developed isolated CNS relapse early post-SCT, while high-dose systemic chemotherapy, intrathecal (IT) triple infusion and IT donor lymphocytes infusion (DLI) all demonstrated effectiveness. We performed IT umbilical cord blood-derived CAR-NK (target CD7) cells infusion, which was not previously reported. After infusion, detection of cytokines revealed that interferon-γ, interleukin-6 and interleukin-8 increased in CSF. He developed high fever, headache, nausea, vomiting and a spinal cord transection with incontinence in a short time, whereas the ptosis and blurred vision improved completely. The bone marrow remained encouragingly complete remission and complete donor chimerism over 9 months after IT CAR-NK cells infusion. In conclusion, IT CAR-NK cells infusion is a potentially feasible and effective option for patients with CNS relapse, with limited neurological toxicity.
Keyphrases
- stem cell transplantation
- nk cells
- high dose
- low dose
- bone marrow
- acute lymphoblastic leukemia
- spinal cord
- blood brain barrier
- mesenchymal stem cells
- umbilical cord
- case report
- systematic review
- oxidative stress
- free survival
- rheumatoid arthritis
- induced apoptosis
- chemotherapy induced
- radiation therapy
- dendritic cells
- rectal cancer
- acute myeloid leukemia
- signaling pathway
- ulcerative colitis
- disease activity
- cell cycle arrest
- loop mediated isothermal amplification
- locally advanced