case_images: PMC8535441_01
case_images: Clinical evolutions after infusion of anti-CD19 and anti-CD22 CAR T-cell cocktail in patients. (A) Levels of serum ferritin after CAR T-cell infusion. (B) Levels of IL-6 after CAR T-cell infusion. (C) Levels of serum CRP after CAR T-cell infusion. (D) Lentiviral copy numbers after CAR T-cell infusion. (E) Dynamic changes in ALT, AST, TBIL, and HBV DNA levels after CAR T-cell infusion. CAR, chimeric antigen receptor; IL-6, interleukin-6; CRP, C-reactive protein; ALT, alanine transaminase; AST, aspartate transaminase; TBIL, total bilirubin.
case_images: fimmu-12-751754-g002.jpg
case_images: PMC8535441_02_fimmu-12-751754-g002.jpg
case_images: f2
case_images: The patient developed mild nausea, vomiting, and fever post-infusion, with peak ferritin level of 2,583 mug/L and IL-6 level of 197.7 pg/ml ( Figures 2A-C ). Lentiviral copy surveillance conducted using qRT-PCR suggested that CAR T-cell expansion reached a maximum point +10 days post-infusion (copy numbers for CD19 6541 and CD22 3602) ( Figure 2D ). ALT (53 U/L)/AST (66 U/L), with mild elevations of TBIL (22.5 mumol/L) and DBIL (20.7 mumol/L) ( Figure 2E ). After ruling out possibilities of obstruction of the PTCD tube and a retest of HBV copy (+14 days, 2.25 x 102 IU/ml) ( Figure 2E ), reactivation of HBV was suspected.
case_images: PMC8535441_02
case_images: Clinical evolutions after infusion of anti-CD19 and anti-CD22 CAR T-cell cocktail in patients. (A) Levels of serum ferritin after CAR T-cell infusion. (B) Levels of IL-6 after CAR T-cell infusion. (C) Levels of serum CRP after CAR T-cell infusion. (D) Lentiviral copy numbers after CAR T-cell infusion. (E) Dynamic changes in ALT, AST, TBIL, and HBV DNA levels after CAR T-cell infusion. CAR, chimeric antigen receptor; IL-6, interleukin-6; CRP, C-reactive protein; ALT, alanine transaminase; AST, aspartate transaminase; TBIL, total bilirubin.
case_images: fimmu-12-751754-g002.jpg
case_images: PMC8535441_02_fimmu-12-751754-g002.jpg
case_images: f2
case_images: The patient developed mild nausea, vomiting, and fever post-infusion, with peak ferritin level of 2,583 mug/L and IL-6 level of 197.7 pg/ml ( Figures 2A-C ). Lentiviral copy surveillance conducted using qRT-PCR suggested that CAR T-cell expansion reached a maximum point +10 days post-infusion (copy numbers for CD19 6541 and CD22 3602) ( Figure 2D ). ALT (53 U/L)/AST (66 U/L), with mild elevations of TBIL (22.5 mumol/L) and DBIL (20.7 mumol/L) ( Figure 2E ). After ruling out possibilities of obstruction of the PTCD tube and a retest of HBV copy (+14 days, 2.25 x 102 IU/ml) ( Figure 2E ), reactivation of HBV was suspected.