case_images: PMC10481705_01
case_images: PMC10481705_02
case_images: Hematology results of the patient from infusion to day 56. (A) Levels of CRP were measured by the left Y-axis, while levels of temperature were measured by the right Y-axis. (B) Levels of serum cytokines. (C) Levels of liver enzyme including alanine transaminase (ALT) and glutamic transaminase (AST). (D) Levels of white blood cells (WBCs). (E) Levels of neutrophils (NEU). (F) Levels of hemoglobin (Hb). (G) Levels of platelet (PLT). (H) Levels of lymphocytes (Lym). (I) Levels of absolute numbers of CD3+ T-cells by flow cytometry. (J) Levels of EBV and HCMV DNA copies.
case_images: 10.1177_09636897231194265-fig1.jpg
case_images: PMC10481705_03_10.1177_09636897231194265-fig1.jpg
case_images: fig1-09636897231194265
case_images: The number of lymphocytes decreased to 0.03 x 109/l within 8 days post-infusion and remained consistently low at less than 0.1 x 109/l for about 7 days (Fig. 1H). Approximately 14 days after infusion, CD3+ T-cells were found to rise in volatility along with the rapid decline of CAR-T cells which dropped to below 0.1% 16 days post-infusion (Fig. 1I). Within the first month after infusion, the patient suffered from virus activation including both Human Cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) (Fig. 1J) exactly during the decline of CD3+ cells, which finally led to viral cystitis manifested as painful urination.
case_images: PMC10481705_03
case_images: Hematology results of the patient from infusion to day 56. (A) Levels of CRP were measured by the left Y-axis, while levels of temperature were measured by the right Y-axis. (B) Levels of serum cytokines. (C) Levels of liver enzyme including alanine transaminase (ALT) and glutamic transaminase (AST). (D) Levels of white blood cells (WBCs). (E) Levels of neutrophils (NEU). (F) Levels of hemoglobin (Hb). (G) Levels of platelet (PLT). (H) Levels of lymphocytes (Lym). (I) Levels of absolute numbers of CD3+ T-cells by flow cytometry. (J) Levels of EBV and HCMV DNA copies.
case_images: 10.1177_09636897231194265-fig1.jpg
case_images: PMC10481705_03_10.1177_09636897231194265-fig1.jpg
case_images: fig1-09636897231194265
case_images: The number of lymphocytes decreased to 0.03 x 109/l within 8 days post-infusion and remained consistently low at less than 0.1 x 109/l for about 7 days (Fig. 1H). Approximately 14 days after infusion, CD3+ T-cells were found to rise in volatility along with the rapid decline of CAR-T cells which dropped to below 0.1% 16 days post-infusion (Fig. 1I). Within the first month after infusion, the patient suffered from virus activation including both Human Cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) (Fig. 1J) exactly during the decline of CD3+ cells, which finally led to viral cystitis manifested as painful urination.
case_images: The efficacy of CD7 CAR-T cells. (A) Timeline of the key clinical events of this patient. (B) The absolute number of CAR-T cells in peripheral blood by flow cytometry. (C) The ratio of CAR- T-cells to CAR+ T-cells in CD3+ T-cells in peripheral blood on day -10, day 10, and day 16. (D) The ratio of CD7- T-cells to CD7+ T-cells was measured in CD8+ T-cells and CD4+ T-cells respectively on day -10, day 10 and day 16. (E) The trend of the ratio of CD7- T-cells to CD7+ T-cells in CD8+ T-cells and CD4+ T-cells from day 0 to day 56 post-infusion.. TCZ: tocilizumab; CRS: cytokine release syndrome; HCMV: human cytomegalovirus; EBV: Epstein-Barr virus; CR: complete remission; HSCT: hematopoietic stem cell transplantation.
case_images: 10.1177_09636897231194265-fig2.jpg
case_images: PMC10481705_03_10.1177_09636897231194265-fig2.jpg
case_images: fig2-09636897231194265
case_images: The detailed adverse events are shown in Table 1, with a brief timeline of the case presented in Fig. 2A. The CAR-T cells demonstrated robust expansion and peaked on day 10 at 3.36 x 107 cells/l (Fig. 2B,C), coinciding with a significant decrease in CD7+ T-cells which reached their lowest levels on day 9 accompanied by an increase in CD7- T-cells (Fig. 2D). Interestingly, CD4+CD7- T-cells seem to predominate the CD7- subset (Fig. 2D, E). Although CD7+ T-cells made up a large majority of T-cells before CAR-T infusion, CD7- T-cells took over the reins even after the reappearance of CD7+ T-cells, especially in the subset of CD4+ cells (Fig. 2E).
case_images: PMC10481705_04
case_images: PMC10481705_05