Case Report: Remission of a patient with complex combination of autoimmune diseases by Anti-CD19 CAR-T cell therapy

Xudong Liu¹Zhu Wenxiang²Nan Su³Yanyi Ma^4*Fang Wang¹Jingyi Xu¹Heyang Zhang³Xiaomeng Luo³Yuetong Zhao¹Jianxun Wang⁴Pingting Yang¹Yishuo Li¹Yuanyuan Shi⁴

• ¹Department of Rheumatology and Immunology, The First Hospital of China Medical University, Shenyang, China
• ²Nanozyme Laboratory in Zhongyuan, Henan academy of Innovations in Medical Science, Zhengzhou, China
• ³Department of Hematology, The First Hospital of China Medical University, Shenyang, China
• ⁴Shenzhen cell valley biopharmaceuticals, Shenzhen, China

CAR-T cell therapy has been proven effective in various autoimmune diseases, with most studies utilizing lentiviral-transduced CAR-T cells. In recent years, retroviral vector-transduced CAR-T cells-characterized by a high positivity rate, stable cell lines, and lower plasmid requirements-have attracted increasing attention. This article presents a complex case of a patient with SLE combined with APS and TBIRS. For four years following the diagnosis, the patient underwent conventional steroid therapy and immunotherapy, which yielded unsatisfactory and relapse-prone results. After receiving anti-CD19 CAR-T cells transduced with a retroviral vector, the patient experienced an excellent postoperative recovery without any infusion-related adverse reactions.Post-treatment, the patient's creatinine, anti-dsDNA antibodies, albumin, and glycated hemoglobin levels returned to normal, eliminating the need for ongoing glucocorticoids or hypoglycemic agents. Although there are some available reports of CAR-T cells treating SLE, it is still very rare and significant for successfully treating such a complicated case, especially after proving the unavailability of traditional therapy.Furthermore, this is the first reported case of treating TBIRS syndrome with retroviral vector-transduced CAR-T therapy.