PMC9198280_01
Manifestations in Case 1. (A1) BM smear before CART therapy showed that immature lymphocytes accounted for 92.1% total cells. (A2) BM smear on day 30 showed that immature lymphocytes accounted for 4.5% total cells. (A3) BM smear on day 41 showed that less than 0.5% immature lymphocytes and about 16% hemophagocytic cells in NEC. (B1) FISH before CART therapy revealed 81% BCR/ABL gene fusion. FISH on day 30 (B2), (B2) FISH on day 30 after CART therapy revealed undetectable BCR/ABL gene fusion after CART therapy revealed undetectable BCR/ABL gene fusion. (C1, C2) BM FCM analysis before CART therapy exhibited 80.9% lymphocytes characterized by CD19+CD22+. (C3, C4) BM FCM analysis on day 30 exhibited 0.21% lymphocytes characterized by CD19+CD22+. (D) qPCR showed detectable CAR19 and CAR22 DNA in peripheral blood after CART therapy. (E1, E2) on day 41.
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Figure 1D ). FCM analysis showed 5.38% CAR cells in the peripheral blood ( Figures 1E1 ,  E2 ). BM smear showed less than 0.5% immature lymphocytes and about 16% hemophagocytic cells in NEC ( Figure 1A3 ).
Manifestations in Case 2. (A1) BM smear before CART therapy showed that plasma cells accounted for 12.5% total cells. (A2) BM smear on day 90 showed that plasma cells accounted for 2.7% total cells. (B) The picture shows that skin rashes with blisters resolved on day 166 (3 days after methylprednisolone treatment). (C1-C3) FISH before CART therapy, on day 90 and on day 163 revealed XY[213]/XX[287], XY[16]/XX[484],and XY[6]/XX[494],respectively. (D1, D2) BM FCM analysis before CART therapy exhibited 50.9% sKappa+ cells. (D3 D4) BM FCM analysis on day 90 after CART therapy exhibited 0.45% sKappa+ cells. (E) FCM analysis showed CAR-BCMA cells in peripheral blood after CART therapy. (F1, F2) FCM analysis showed 1.03% CAR cells in the peripheral blood on day 163.
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Within 3 days, patient's condition gradually improved with the normalization of body temperature (36.7 C) and blood pressure (123/79 mmHg), unprogressive rashes ( Figure 2B ), as well as descending ferritin and IL-6 levels ( Table 2 ).
PMC9198280_02
Manifestations in Case 1. (A1) BM smear before CART therapy showed that immature lymphocytes accounted for 92.1% total cells. (A2) BM smear on day 30 showed that immature lymphocytes accounted for 4.5% total cells. (A3) BM smear on day 41 showed that less than 0.5% immature lymphocytes and about 16% hemophagocytic cells in NEC. (B1) FISH before CART therapy revealed 81% BCR/ABL gene fusion. FISH on day 30 (B2), (B2) FISH on day 30 after CART therapy revealed undetectable BCR/ABL gene fusion after CART therapy revealed undetectable BCR/ABL gene fusion. (C1, C2) BM FCM analysis before CART therapy exhibited 80.9% lymphocytes characterized by CD19+CD22+. (C3, C4) BM FCM analysis on day 30 exhibited 0.21% lymphocytes characterized by CD19+CD22+. (D) qPCR showed detectable CAR19 and CAR22 DNA in peripheral blood after CART therapy. (E1, E2) on day 41.
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Figure 1D ). FCM analysis showed 5.38% CAR cells in the peripheral blood ( Figures 1E1 ,  E2 ). BM smear showed less than 0.5% immature lymphocytes and about 16% hemophagocytic cells in NEC ( Figure 1A3 ).
Manifestations in Case 2. (A1) BM smear before CART therapy showed that plasma cells accounted for 12.5% total cells. (A2) BM smear on day 90 showed that plasma cells accounted for 2.7% total cells. (B) The picture shows that skin rashes with blisters resolved on day 166 (3 days after methylprednisolone treatment). (C1-C3) FISH before CART therapy, on day 90 and on day 163 revealed XY[213]/XX[287], XY[16]/XX[484],and XY[6]/XX[494],respectively. (D1, D2) BM FCM analysis before CART therapy exhibited 50.9% sKappa+ cells. (D3 D4) BM FCM analysis on day 90 after CART therapy exhibited 0.45% sKappa+ cells. (E) FCM analysis showed CAR-BCMA cells in peripheral blood after CART therapy. (F1, F2) FCM analysis showed 1.03% CAR cells in the peripheral blood on day 163.
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Within 3 days, patient's condition gradually improved with the normalization of body temperature (36.7 C) and blood pressure (123/79 mmHg), unprogressive rashes ( Figure 2B ), as well as descending ferritin and IL-6 levels ( Table 2 ).
PMC9198280_03
PMC9198280_04
Manifestations in Case 2. (A1) BM smear before CART therapy showed that plasma cells accounted for 12.5% total cells. (A2) BM smear on day 90 showed that plasma cells accounted for 2.7% total cells. (B) The picture shows that skin rashes with blisters resolved on day 166 (3 days after methylprednisolone treatment). (C1-C3) FISH before CART therapy, on day 90 and on day 163 revealed XY[213]/XX[287], XY[16]/XX[484],and XY[6]/XX[494],respectively. (D1, D2) BM FCM analysis before CART therapy exhibited 50.9% sKappa+ cells. (D3 D4) BM FCM analysis on day 90 after CART therapy exhibited 0.45% sKappa+ cells. (E) FCM analysis showed CAR-BCMA cells in peripheral blood after CART therapy. (F1, F2) FCM analysis showed 1.03% CAR cells in the peripheral blood on day 163.
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Within 3 days, patient's condition gradually improved with the normalization of body temperature (36.7 C) and blood pressure (123/79 mmHg), unprogressive rashes ( Figure 2B ), as well as descending ferritin and IL-6 levels ( Table 2 ).
PMC9198280_05
Manifestations in Case 2. (A1) BM smear before CART therapy showed that plasma cells accounted for 12.5% total cells. (A2) BM smear on day 90 showed that plasma cells accounted for 2.7% total cells. (B) The picture shows that skin rashes with blisters resolved on day 166 (3 days after methylprednisolone treatment). (C1-C3) FISH before CART therapy, on day 90 and on day 163 revealed XY[213]/XX[287], XY[16]/XX[484],and XY[6]/XX[494],respectively. (D1, D2) BM FCM analysis before CART therapy exhibited 50.9% sKappa+ cells. (D3 D4) BM FCM analysis on day 90 after CART therapy exhibited 0.45% sKappa+ cells. (E) FCM analysis showed CAR-BCMA cells in peripheral blood after CART therapy. (F1, F2) FCM analysis showed 1.03% CAR cells in the peripheral blood on day 163.
fonc-12-893928-g002.jpg
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Within 3 days, patient's condition gradually improved with the normalization of body temperature (36.7 C) and blood pressure (123/79 mmHg), unprogressive rashes ( Figure 2B ), as well as descending ferritin and IL-6 levels ( Table 2 ).
PMC9198280_06
Manifestations in Case 2. (A1) BM smear before CART therapy showed that plasma cells accounted for 12.5% total cells. (A2) BM smear on day 90 showed that plasma cells accounted for 2.7% total cells. (B) The picture shows that skin rashes with blisters resolved on day 166 (3 days after methylprednisolone treatment). (C1-C3) FISH before CART therapy, on day 90 and on day 163 revealed XY[213]/XX[287], XY[16]/XX[484],and XY[6]/XX[494],respectively. (D1, D2) BM FCM analysis before CART therapy exhibited 50.9% sKappa+ cells. (D3 D4) BM FCM analysis on day 90 after CART therapy exhibited 0.45% sKappa+ cells. (E) FCM analysis showed CAR-BCMA cells in peripheral blood after CART therapy. (F1, F2) FCM analysis showed 1.03% CAR cells in the peripheral blood on day 163.
fonc-12-893928-g002.jpg
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Within 3 days, patient's condition gradually improved with the normalization of body temperature (36.7 C) and blood pressure (123/79 mmHg), unprogressive rashes ( Figure 2B ), as well as descending ferritin and IL-6 levels ( Table 2 ).