PMC9226330_01
Positron-emission tomography-computed tomography before and 3 months after CAR-T cell infusion. (A) PET-CT image of the patient before the CAR-T cell infusion, showing lymphoma invasion. (B) PET-CT image of the patient 3 months after the CAR-T cell infusion, showing no lesions and complete remission. The axial image (left) and coronal image (right) are shown. Red arrows indicate lymphoma lesions.
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Pretreatment PET-CT showed a large lung mass with multiple lymph node involvements (Figure 1A). PET-CT examination confirmed complete metabolic remission 3 months after CAR-T cell therapy (Figure 1B).
Computed tomography and CAR-T cell monitoring after CAR-T infusion. (A) Axial CT image at relapse after CAR-T therapy. (B) Axial CT image before the combination treatment of chidamide and zanubrutinib, showing disease progression. (C) Axial CT image 2 months after the combination treatment of chidamide and zanubrutinib, showing disease remission. (D) CAR-T cell monitoring after CAR-T cell infusion. (E)Timeline of diagnosis and treatment. "*" means "times" (or multiply).
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Unfortunately, 12 months after CAR-T infusion, the patient relapsed for the fourth time with lung mass (Figure 2A), which was confirmed by biopsy. However, the patient failed to achieve any remission and lung lesion progressed with increasing pleural effusion (Figure 2B). Surprisingly, his symptoms were relieved after 2 weeks of this treatment, and a CT scan 2 months later showed significant remission of lung lesions (Figure 2C). Peripheral blood CAR-T cells of the entire course management were monitored of this patient (Figure 2D). The timeline of diagnosis and treatment was shown in Figure 2E.