Abstract
Anti-CD19 chimeric antigen receptor (CAR) T cells have been shown to be an effective treatment for relapsed/refractory B-cell hematological malignancies, especially diffuse large-cell B-cell lymphomas (DLBCL). The infusion of CAR T cells is associated with well-described acute complications such as sepsis, cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome. To date, no case of delayed lung toxicity has been described. Here, we report three cases of patients treated for R/R DLBCL who presented a delayed pulmonary complication following CAR T cells infusion. From 3 to 12 months following treatment, all patients developed febrile cough and mild to severe dyspnea. Lung computed tomography scan showed diffuse bilateral ground glass opacities and consolidations consistent with an organizing pneumonia pattern. After an infectious process and hypothesis of lymphoma relapse were ruled out, the diagnosis of CAR T cell lung toxicity was retained. Two patients were treated with corticosteroids, with both clinical and radiological improvement. The third patient had a concomitant diagnosis of polyarthritis and was treated with tocilizumab with subsequent improvement in respiratory symptoms and radiological resolution. This case series suggests that pulmonary complications can occur late after CAR T cells infusion and that they may be similar to those observed after allogeneic hematopoietic stem cell.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 746.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020