CASE REPORT article
Front. Oncol.
Sec. Hematologic Malignancies
Case Report: Rare Adverse Events Following CAR-T Therapy in Patients with Relapsed/Refractory Diffuse Large B-Cell Lymphoma
Provisionally accepted
- 1Saint Louis University School of Medicine, St Louis, United States
- 2Department of Hematology Oncology, SSM Health St Louis University Hospital, St Louis, United States
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Chimeric antigen receptor T-cell (CAR-T) therapy is a significant development in cancer therapy that is used to treat B-cell malignancies including B cell lymphoblastic leukemias, relapsed and refractory lymphomas, and multiple myeloma. CAR-T requires T-cell collection from the patient, which is genetically engineered to express a synthetic receptor that will bind to an antigen of a specific tumor. The CAR-T cells are then infused back into the patient, which function to attack the resistant cancer cells. Reported side effects of CAR-T include cytokine-release syndrome (CRS), macrophage activation syndrome (MAS), and immune effector cell-associated neurotoxicity syndrome (ICANS). Sometimes, patients can experience rare side effects which are not reported as often due to the rarity. We present a series of three patients with relapsed/refractory diffuse large B-cell lymphoma, who each received CAR-T therapy with Axicabtagene ciloleucel. Each patient developed unique and unprecedented adverse effects in the time following infusion of CAR-T. This includes manifestations of autoimmune demyelination and myelopathy, bullous dermatologic reactions on the lower extremities, and bilateral enlarged parotid glands as a result of CAR-T.
Keywords: DLBCL - Diffuse large B cell lymphoma, car-t, ICANS - immune effector cell-associated neurotoxicity syndrome, immune-mediated, Chimeric antigen receptor (CAR T)
Received: 10 Jun 2025; Accepted: 29 Oct 2025.
Copyright: © 2025 Shah and Kunwor. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ziniya Shah, ziniyashah1412@gmail.com
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