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Case Reports
. 2023 Jan 13;30(1):1146-1150.
doi: 10.3390/curroncol30010087.

Fatal Progression of Mutated TP53-Associated Clonal Hematopoiesis following Anti-CD19 CAR-T Cell Therapy

Lea Naomi Eder  1 , Danilo Martinovic  1 , Paolo Mazzeo  1 , Christina Ganster  1 , Justin Hasenkamp  1 , Julia Thomson  1 , Arne Trummer  2 , Detlef Haase  1 , Gerald Wulf  1
Affiliations
Case Reports

Fatal Progression of Mutated TP53-Associated Clonal Hematopoiesis following Anti-CD19 CAR-T Cell Therapy

Lea Naomi Eder et al. Curr Oncol. .

Abstract

We present the case of a 64-year-old man diagnosed with large B-cell lymphoma who relapsed twice after standard-of-care therapy. Due to persisting cytopenia, Next generation sequencing analysis was performed, revealing a small TP53-mutated clone. As a third-line therapy, the patient was treated with CAR-T cells, which resulted in complete remission. However, this treatment also led to the expansion of the TP53-mutated clone and therapy-related myelodysplasia with a complex aberrant karyotype. This case may serve as a paradigmatic example of clonal hematopoietic progression in a patient undergoing CAR-T cell therapy, especially in the context of a TP53-mutated clone.

Keywords: CAR-T cell therapy; clonal evolution; clonal hematopoiesis; therapy-related neoplasia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Evolution of the TP53-mutated clone.
See this image and copyright information in PMC

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