Shenzhen News, February 14, 2023 (Reporter Liu Mengting, Correspondent Wang Lixin, Wang Suqi) Diffuse large B-cell lymphoma is a relatively common type of non-Hodgkin’s lymphoma, which is an aggressive lymphoma with a high degree of malignancy. Very high, the course of the disease progresses rapidly, and without active treatment, the median survival time is less than 1 year. In recent years, the new CAR-T cell therapy of relapsed/refractory B-cell lymphoma carried out by the Department of Hematology and Oncology of Shenzhen University General Hospital has brought “life” hope to many lymphoma patients who are in desperate situations.
Stomachache was found to be lymphoma, repeated chemotherapy “can’t see hope”
In March 2020, Mr. Wang (pseudonym) suddenly had a stomachache. At that time, he thought it was intestinal discomfort, so he did not see a doctor. But after more than 2 months, he had recurring lower right abdominal pain, so he went to the local hospital and had abdominal CT examination, which indicated abnormal colon and enlarged retroperitoneal lymph nodes. The doctor suggested colonoscopy + biopsy to confirm the diagnosis. After pathological biopsy, the diagnosis was “diffuse large B-cell lymphoma”, a malignant tumor, commonly known as lymphoma. Further examination of PET-CT showed: multiple nodular hypermetabolic lesions in multiple parts of the body, the largest of which was 4.3*4.1*4.5cm.
vicious. Diffusion has occurred. One bad news after another, like a bolt from the blue. With the support of his family, Mr. Wang received 4 courses of R-CHOP chemotherapy. After the chemotherapy, PET-CT was re-examined, and the treatment effect was partial remission.
However, during the follow-up chemotherapy, Mr. Wang developed severe complications such as intestinal obstruction, intestinal perforation, and acute peritonitis. Symptoms are under control.
Re-examination of PET-CT showed that the number of tumor lesions increased and increased. In order to remove tumor cells more effectively, the doctor adjusted the intensive chemotherapy regimen and recommended a hematopoietic stem cell transplantation regimen. After two courses of chemotherapy, Mr. Wang planned to give it a go and receive a transplant, but was told that after evaluation, the tumor burden was heavy and he was not suitable for transplantation.
After repeated blows, he suffered great physical and mental pain, and his condition became more and more serious. Mr. Wang’s health deteriorated. Tumor infiltration appeared in many parts of the psoas major muscle and erector spinae, and multiple new hypermetabolic lesions appeared in his body. The scope of the cancer focus was significantly larger than before. Because of the multiple tumors in his body, Mr. Wang has been in pain all over his body, unable to lie flat and sleep, and often cannot sleep because of the pain.
“Complete remission” after more than a year of CAR-T treatment
Mr. Wang felt very desperate and didn’t know what to do next. In the day-to-day suffering, the family members found out that the team of Professor Yu Li from the Department of Hematology and Oncology of Shenzhen University General Hospital had carried out a “clinical study of CD19/CD20 dual-target CAR-T cells in the treatment of relapsed/refractory B-cell lymphoma”. “Research” is a new type of effective CAR-T treatment specially provided for patients with relapsed or refractory B-cell lymphoma after conventional treatment.
The last glimmer of light in a desperate situation. After consideration, Mr. Wang and his family are willing to join the clinical research. Before treatment, a biopsy of the right inguinal lymph node was performed, and the consultation with pathologists showed that CD19 and CD20 were positive, which also provided an accurate target for CAR-T cell immunotherapy. In addition, Professor Yu Li organized experts to conduct a detailed and comprehensive physical examination for the patient. Checked, and developed an individualized CAR-T treatment plan for the patient.
On July 23, 2021, Mr. Wang received reinfusion of CD19/20 CAR-T cells in the laminar flow ward of the Department of Hematology and Oncology, Shenzhen University General Hospital. After strict symptomatic and supportive treatment, it was controlled without serious life-threatening complications.
In less than three months, on October 10, PET-CT was re-examined, and the comprehensive evaluation of the curative effect has achieved complete remission, and all physical indicators tended to be normal. The treatment was very successful.
In the follow-up follow-up, Mr. Wang regularly reviewed CT or MRI or PET-CT examinations, all of which indicated a complete remission status. So far, he is in good physical condition, and the complete remission period has exceeded 14 months.
Comparison of PET-CT before and after CAR-T treatment of patient Mr. Wang
90% of formally enrolled patients achieved initial “complete remission “
Currently, 90% of the patients participating in the “CD19/CD20 dual-targeted CAR-T cell therapy clinical study for relapsed/refractory B-cell lymphoma” in the Department of Hematology and Oncology, Shenzhen University General Hospital achieved complete remission at the initial stage, and all patients were able to Significant expansion of peripheral blood CAR-T cells was seen, and no serious complications occurred, which is safe and effective overall.
In the long-term follow-up of some patients, it was found that the infused patient’s autologous CAR-T cells could still detect long-term and viable CAR-T cells after 460 days, which theoretically could curb tumor recurrence for a long time.
Comparison of some patients before and after CAR-T treatment
Professor Yu Li, the leader of the Department of Hematology and Oncology at Shenzhen University General Hospital, is a well-known expert in the field of hematology and solid tumors in China. As the winner of the National Science and Technology Progress Award, the undertaker of major national science and technology projects and key projects of the National Natural Science Foundation of China, Professor Yu Li has worked in the General Hospital of the Chinese People’s Liberation Army (301) for more than 30 years. He is the chairman of the Professional Committee for Precision Diagnosis and Treatment of Hematology. He has rich experience in clinical research. He has presided over more than 20 international and domestic multi-center clinical trials of marketed drugs, and presided over more than 10 clinical trials initiated by investigators.
Led by Professor Yu Li, the team of Carlson International Cancer Center and Shenzhen University-Haoshi Institute of Cell Therapy has long been committed to the research of CAR-T cell immunotherapy for hematological tumors and solid tumors, with particular emphasis on new target CAR-T for advanced tumors. clinical treatment of patients. Since Professor Li led the Department of Hematology and Oncology of Shenzhen University General Hospital to preside over the clinical enrollment treatment, and Haoshi Cell Therapy Research Institute undertook the transformation and production of CAR-T cells, the Department of Hematology and Oncology of Shenzhen University General Hospital took the lead in carrying out CD19-20 as the target in Shenzhen. The new CAR-T cell therapy of the point of view has achieved excellent clinical results in the treatment of relapsed/refractory B-cell lymphoma.
Source: Shenzhen News Network