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<p>Patients with primary plasma cell leukemia (pPCL), particularly those with extramedullary disease (EMD), face a poor prognosis even with chimeric antigen receptor (CAR)-T cell therapy. This case report describes a patient with relapsed/refractory pPCL and life-threatening malignant pleural effusion (PE) treated with intrapleural CAR-T cells targeting B-cell maturation antigens. CAR-T cell expansion within the PE was observed, along with a rapid reduction in leukemia cell count and PE volume. Subsequent lymphodepletion chemotherapy and intravenous CAR-T cell therapy induced complete remission with 9 months of progression-free survival. This case highlights the potential advantages of integrating local and systemic CAR-T cell therapy in managing complex EMD cases.</p>

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Sequential intrathoracic injection and intravenous infusion of BCMA CAR-T cells in a patient with relapsed/refractory primary plasma cell leukemia

  • 期刊论文

  • 发表日期：

    2025年9月10日

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  • Wei Han,
  • Shuyang Wang,
  • Mingming Zhang,
  • Shan Fu,
  • Wenjun Wu,
  • Houli Zhao,
  • Ka Wai Wong,
  • Sze Fai Yip,
  • Jiazhen Cui,
  • Alex H. Chang,
  • Guoqing Wei,
  • He Huang,
  • Yongxian Hu

摘要

Patients with primary plasma cell leukemia (pPCL), particularly those with extramedullary disease (EMD), face a poor prognosis even with chimeric antigen receptor (CAR)-T cell therapy. This case report describes a patient with relapsed/refractory pPCL and life-threatening malignant pleural effusion (PE) treated with intrapleural CAR-T cells targeting B-cell maturation antigens. CAR-T cell expansion within the PE was observed, along with a rapid reduction in leukemia cell count and PE volume. Subsequent lymphodepletion chemotherapy and intravenous CAR-T cell therapy induced complete remission with 9 months of progression-free survival. This case highlights the potential advantages of integrating local and systemic CAR-T cell therapy in managing complex EMD cases.