case_images: PMC6904344_01
case_images: Brain MRI (A) the residual mass on the right side of the post-operative cavity, which was ~26 mm*35 mm*30 mm (arrow) in volume, and the mass disappeared 1 month after infusion (B). No relapse occurred in subsequent follow-up (C).
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case_images: F1
case_images: MRI suggested a residual mass (26 mm*35 mm*30 mm) on the right side of the post-operative cavity and stale hemorrhage in the left basal ganglia (Figure 1A). One month after CAR T-cell infusion, restaging cranial MRI indicated that the lesion area in the right temporal parietal lobe had disappeared (Figure 1B). In April 2019, 17 months later, MRI suggested that the patient had achieved durable remission (Figure 1C).
case_images: PET/CT images before (Right) and after (Left) CAR T-cell infusion. The position indicated by the arrow is the location of the lesion.
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case_images: F2
case_images: PET/CT imaging confirmed no space occupying mass (Figure 2).
case_images: The levels of fourth-generation CART19 and CART70 cells in peripheral blood at the indicated time points after CAR T-cell infusion. Both 4SCAR19 and 4SCAR70 reached their peaks in the peripheral blood on day 7, with the former accounting for 2.28% of circulating mononuclear cells and the latter accounting for 0.46%.
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case_images: PMC6904344_01_fonc-09-01350-g0003.jpg
case_images: F3
case_images: T-cells in the peripheral blood peaked on day 7, with the 4SCAR19 in the peripheral blood accounting for ~2.28% of circulating mononuclear cells, while the 4SCAR70 was 0.46% of circulating mononuclear cells. 4SCAR19 and 4SCAR70 showed similar expansion kinetics in vivo. The amplification of CAR19 T-cells was more pronounced than that of the CAR70 T-cells (Figure 3).
case_images: The concentrations of interleukin (IL)-1beta, IL-6, IL-8, and IL-10 in plasma (A) and cerebrospinal fluid (CSF) (B) before and after CAR T-cell infusion. On day 29 after the infusion, the cytokines of the peripheral blood reached their highest peak, with IL-8 296 pg/mL and IL-1beta 177 pg/mL. In CSF, both IL- 6 and IL-8 showed a downward trend after infusion, while IL-1beta and IL-10 remained at low levels.
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case_images: F4
case_images: T-cells were detectable more than 10 months after CAR T-cell infusion. The concentrations of cytokines, including IL-1beta, IL-6, IL-8, and IL-10, in his plasma and CSF was tested by flow cytometry at regular intervals (Figure 4).