EBV-associated lymphoproliferative disease post-CAR-T cell therapy

• DOI: 10.1007/s11684-023-1032-8
• Publication Date: 2024-02-08T10:02:17Z
• Authors: Shiyuan Zhang; Xiaoxi Zhou; Shangkun Zhang; Na Wang; Tongcun Zhang; Donghua Zhang; Qilin Ao; Yang Cao; Liang Huang
• Keywords: Lymphoproliferative Disorders; Cell therapy

Epstein-Barr virus (EBV)-associated lymphoproliferative diseases (EBV-LPDs) are common complications that occur after solid organ transplantation or allogeneic hematopoietic stem-cell transplantation (HSCT). However, their occurrence and treatment post-chimeric antigen receptor-modified T (CAR-T) cell therapy has not been reported. Two patients had been diagnosed with EBV-positive aggressive B-cell lymphoma and experienced relapses after multiple lines of treatment. After receiving CAR-T cell therapy in tandem with autologous HSCT, the patients achieved complete remission. However, with a median time of 38.5 months after CAR-T cell therapy, B-cell-derived EBV-LPDs were diagnosed, and they were relieved through the administration of immune checkpoint inhibitor or B-cell-depleting agents. Collectively, our report suggests that EBV-LPDs may represent a long-term adverse event after CAR-T cell therapy, especially in patients who previously had EBV-positive disorders, and they can be resolved by immune normalization strategy or B-cell depleting therapy.