Immune imitation of tumor progression after anti-CD19 chimeric antigen receptor T cells treatment in aggressive B-cell lymphoma

Ivetta Danylesko*, Roni Shouval, Noga Shem-Tov, Ronit Yerushalmi, Elad Jacoby, Michal J. Besser, Avichai Shimoni, Tima Davidson, Katia Beider, Dror Mevorach, Shalev Fried, Arnon Nagler, Abraham Avigdor

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

We present three patients with aggressive non-Hodgkin’s B-cell lymphoma (NHL) who received anti-CD19 chimeric antigen receptor T (CAR T) cells therapy after failure of several lines of chemotherapy that developed pseudo-progression. One-week clinical and radiological findings were consistent with tumor progression. Positron emission tomography-computed tomography (PET-CT) at 1 month post CAR T cells administration was consistent with treatment response. The rapid tumor growth and subsequent resolution are suggestive of tumor pseudo-progression mediated secondary to infiltration and immune activation of CAR T cells. Overall, 56 adult patients with NHL were enrolled in a phase 1b/2 in house clinical study with CD19 CAR T cells. Out of them 22/56 patients progressed as per PET-CT the 1 month post CAR T cells. In 14 patients, signs of progression started 7–10 days after CAR T cells infusion. In 11/14 patients, it was true progression, while in 3 it was pseudo-progression. Additional studies are warranted to describe the extent of this phenomenon and evaluate correlation with the CAR T activity and long-term disease control.

Original languageEnglish
Pages (from-to)1134-1143
Number of pages10
JournalBone Marrow Transplantation
Volume56
Issue number5
DOIs
StatePublished - May 2021

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