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Case Reports
. 2022 Jun;14(8):599-607.
doi: 10.2217/imt-2021-0247. Epub 2022 Apr 20.

Pathologically complete remission to combination of invariant NK T cells and anti-CD20 antibody in a refractory HIV+ diffuse large B-cell lymphoma patient

Jing Wang  1 , Renfang Zhang  1 , Xiangqing Ding  1 , Yanling Jin  1 , Ran Qin  1 , Bili Xia  1 , Qibin Liao  1 , Huiliang Hu  1 , Wei Song  1 , Zhenyan Wang  1 , Xiaoyan Zhang  2 , Jianqing Xu  2
Affiliations
Case Reports

Pathologically complete remission to combination of invariant NK T cells and anti-CD20 antibody in a refractory HIV+ diffuse large B-cell lymphoma patient

Jing Wang et al. Immunotherapy. 2022 Jun.

Abstract

Although there is a high curability rate with rituximab chemotherapy, approximately 40% of patients with diffuse large B-cell lymphoma (DLBCL) develop disease relapse or primary-refractory lymphoma. The prognosis of HIV+ DLBCL patients is even worse with limited therapeutic options. The case is presented of a 28-year-old man who was diagnosed with HIV-DLBCL, refractory to rituximab-based chemo-immunotherapies and radiotherapy before and maintained a pathologically complete regression with the infusion of haplotype-matched invariant NK T cells and anti-CD20 antibody. His abdominal mass kept shrinking during the period of follow-up without relapse to date. A combination of haplotype-matched invariant NK T cells was likely to reinvigorate the efficacy of anti-CD20 antibody and may offer a viable treatment option for refractory DLBCL patients.

Keywords: DLBCL; HIV+; anti-CD20 antibody; chemo-immunotherapy; iNKT; pathologically complete regression; relapsed/refractory; rituximab.

Plain language summary

Diffuse large B-cell lymphoma (DLBCL) is one of the most frequent types of lymphoid cancer. The prognosis of relapsed/refractory DLBCL patients has been dismal with resistance to rituximab-based chemo-immunotherapy. The combination of effective cells with rituximab might improve clinical response by enhancing antibody-dependent cytotoxicity. The authors reported the case of a 28-year-old man diagnosed with HIV-DLBCL, refractory to 3 lines of rituximab-based chemo-immunotherapies and radiotherapy before, and who received 6 experimental infusions of haplotype-matched invariant NK T cells combined with anti-CD20 antibody. The lesion on radiological examination was partially regressed after cycle 3 and cycle 6. The pathological examination, performed 4 weeks after cycle 6, suggested pathologically complete regression. The mass was completely regressed on CT scanning without relapse to date. A combination of invariant NK T cells and anti-CD20 antibody may offer a viable treatment option for relapsed/refractory DLBCL patients for whom rituximab chemotherapy was not effective.

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