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10.1038/mt.2015.60

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suck abstract from ncbi


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pmid25896248
      Mol+Ther 2015 ; 23 (9 ): 1541-50
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  • Case Report of a Fatal Serious Adverse Event Upon Administration of T Cells Transduced With a MART-1-specific T-cell Receptor #MMPMID25896248
  • van den Berg JH ; Gomez-Eerland R ; van de Wiel B ; Hulshoff L ; van den Broek D ; Bins A ; Tan HL ; Harper JV ; Hassan NJ ; Jakobsen BK ; Jorritsma A ; Blank CU ; Schumacher TN ; Haanen JB
  • Mol Ther 2015[Sep]; 23 (9 ): 1541-50 PMID25896248 show ga
  • Here, we describe a fatal serious adverse event observed in a patient infused with autologous T-cell receptor (TCR) transduced T cells. This TCR, originally obtained from a melanoma patient, recognizes the well-described HLA-A*0201 restricted 26-35 epitope of MART-1, and was not affinity enhanced. Patient 1 with metastatic melanoma experienced a cerebral hemorrhage, epileptic seizures, and a witnessed cardiac arrest 6 days after cell infusion. Three days later, the patient died from multiple organ failure and irreversible neurologic damage. After T-cell infusion, levels of IL-6, IFN-?, C-reactive protein (CRP), and procalcitonin increased to extreme levels, indicative of a cytokine release syndrome or T-cell-mediated inflammatory response. Infused T cells could be recovered from blood, broncho-alveolar lavage, ascites, and after autopsy from tumor sites and heart tissue. High levels of NT-proBNP indicate semi-acute heart failure. No cross reactivity of the modified T cells toward a beating cardiomyocyte culture was observed. Together, these observations suggest that high levels of inflammatory cytokines alone or in combination with semi-acute heart failure and epileptic seizure may have contributed substantially to the occurrence of the acute and lethal event. Protocol modifications to limit the risk of T-cell activation-induced toxicity are discussed.
  • |Adult [MESH]
  • |Cell- and Tissue-Based Therapy/*adverse effects/methods [MESH]
  • |Fatal Outcome [MESH]
  • |Female [MESH]
  • |Humans [MESH]
  • |Immunotherapy, Adoptive/*adverse effects/methods [MESH]
  • |Lymphocytes, Tumor-Infiltrating/immunology/metabolism [MESH]
  • |MART-1 Antigen/*immunology/metabolism [MESH]
  • |Melanoma/diagnosis/genetics/immunology/therapy [MESH]
  • |Neoplasm Staging [MESH]
  • |Receptors, Antigen, T-Cell/*genetics/metabolism [MESH]
  • |T-Cell Antigen Receptor Specificity/*immunology [MESH]
  • |T-Lymphocytes/*immunology/*metabolism [MESH]


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