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Sequential anti-CD19, 22, and 20 autologous chimeric antigen receptor T-cell (CAR-T) treatments of a child with relapsed refractory Burkitt lymphoma: a case report and literature review

  • Original Article – Clinical Oncology
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

A Correction to this article was published on 25 May 2020

This article has been updated

Abstract

Purpose

Burkitt lymphoma (BL) is one of the most frequent subtypes of non-Hodgkin lymphoma (NHL) in children. Currently, short, intensive chemotherapy is used internationally and has greatly improved survival in children with BL. However, 5–10% of patients suffer recurrence after intensive chemotherapy, and the prognosis of these patients remains poor. The overall survival rate is only approximately 10%. Innovative therapies are needed to attain a higher rate of remission, such as immunotherapy for relapsed refractory (r/r) BL patients.

Methods

An 8-year-old boy with BL was studied. He suffered a relapse after treatment with standard chemotherapy. Then, we treated this patient using autologous chimeric antigen receptor T-cell (CAR-T) therapies, sequentially targeting antigens CD19, CD22, and CD20. A review of the current literature on CAR-T treatment for lymphoma is presented.

Results

The patient had no discernible response to anti-CD19 CAR-T treatment and exhibited progressive disease (PD). Following CD-22-directed CAR-T treatment, the patient underwent a partial remission (PR), but unfortunately a relapse rapidly occurred. Finally, after administering the anti-CD20 CAR-T cell therapy, the child went into complete remission (CR). The young boy has currently achieved 16-month event-free survival (EFS) so far. During administration of the CD19 and CD20 CAR-T cells, the patient appeared to experience mild (Grade I) cytokine release syndrome (CRS). However, during the CD22 CAR-T therapy, he appeared to experience grade III CRS.

Conclusion

Autologous anti-CD19, anti-CD22, and anti-CD20 CAR-T cell therapies targeting multiple tumor antigens could be an innovative and sound treatment for children with r/r BL, provided that they are closely monitored during treatment.

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Data availability

Available upon request.

Change history

  • 25 May 2020

    In the original article published, the first author���s affiliation is incorrect.

Abbreviations

BL:

Burkitt lymphoma

CAR-T cell:

Chimeric antigen receptor T cell

CRES:

CAR-T cell-related encephalopathy syndrome

PD:

Progressive disease

PR:

Partial remission

CR:

Complete remission

CRP:

C-reactive protein

CRS:

Cytokine release syndrome

EFS:

Event-free survival

NHL:

Non-Hodgkin lymphoma

PET:

Positron emission tomography

r/r:

Relapsed refractory

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Acknowledgements

We gratefully acknowledge Bo Hu, Wenqun Zhang, and other members of Children’s Lymphoma Ward, Beijing Boren Hospital for their invaluable assistance throughout the preparation of original manuscript. Many thanks to Ling Jin and Jing Yang (Department of Hematology Oncology, National Center for Children’s Health, Beijing Children’s Hospital) providing technical assistance and giving us advice of great value.

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Authors and Affiliations

  1. Tianjin Medical University, Tianjin, 300070, China

    Juan Du

  2. Children’s Lymphoma Ward, Beijing Boren Hospital, Beijing, 100070, China

    Yonghong Zhang

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  1. Juan Du
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JD drafted the manuscript. YZ revised and edited the manuscript multiple times. All authors have read and approved the final manuscript.

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Correspondence to Yonghong Zhang.

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The authors declare that they have no conflict of interests.

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Written informed consent was obtained from the patient’s guardian for the analysis of the samples and the tissues. Consent for publication was obtained from the patient’s guardian.

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Du, J., Zhang, Y. Sequential anti-CD19, 22, and 20 autologous chimeric antigen receptor T-cell (CAR-T) treatments of a child with relapsed refractory Burkitt lymphoma: a case report and literature review. J Cancer Res Clin Oncol 146, 1575–1582 (2020). https://doi.org/10.1007/s00432-020-03198-7

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