Pembrolizumab for the treatment of progressive multifocal leukoencephalopathy following anti-CD19 CAR-T therapy: a case report.
checkpoint inhibition
chimeric antigen receptor T‐ cell
herald lesion
immune reconstitution inflammatory syndrome
pembrolizumab
progressive multifocal leukoencephalopathy
Journal
EJHaem
ISSN: 2688-6146
Titre abrégé: EJHaem
Pays: United States
ID NLM: 101761942
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
02
06
2021
revised:
18
07
2021
accepted:
20
07
2021
entrez:
18
7
2022
pubmed:
19
7
2022
medline:
19
7
2022
Statut:
epublish
Résumé
Progressive multifocal leukoencephalopathy (PML) is an opportunistic brain infection with few treatment options and poor survival when reversal of the underlying immune dysfunction is not achievable. JC polyomavirus reactivation resulting in PML can rarely complicate chimeric antigen receptor T-cell (CAR-T) therapy. We describe successful treatment of PML with Programmed death-1 (PD-1) blockade using pembrolizumab, 4 months following axicabtagene ciloleucel. Radiological features of immune reconstitution inflammatory syndrome without clinical deterioration were seen. Evidence of anti-viral immune reconstitution by in vitro detection of JC-specific T-cells and sustained neurological recovery in this patient suggest PD-1 blockade may be an effective treatment approach for PML post-CAR-T.
Identifiants
pubmed: 35845220
doi: 10.1002/jha2.274
pii: JHA2274
pmc: PMC9281485
doi:
Types de publication
Case Reports
Langues
eng
Pagination
848-853Informations de copyright
© 2021 The Authors. eJHaem published by British Society for Haematology and John Wiley & Sons Ltd.
Déclaration de conflit d'intérêts
The authors declare that they have no conflict of interest. TM, KT and CR are supported by the UK National Institute of Health Research University College London Hospital Biomedical Research Centre (BRC).
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