Case report: Hashimoto's thyroiditis after CD19 chimeric antigen receptor T-cell therapy

Area of Science:

• Immunotherapy
• Oncology
• Endocrinology

Background:

• Chimeric antigen receptor (CAR)-T cell therapy is an effective treatment for relapsed refractory B-cell lymphoma.
• CAR T-cell therapy can cause various adverse effects, but immune-related adverse reactions are rare.
• Immune checkpoint inhibitors are known to cause immune-related adverse events, including thyroid dysfunction.

Observation:

• Two patients with relapsed refractory diffuse large B-cell lymphoma developed Hashimoto's thyroiditis after CAR T-cell therapy.
• These patients exhibited elevated peroxidase and globulin antibodies following treatment.
• Complete remission of lymphoma was achieved in both patients.

Findings:

• CAR T-cell therapy was associated with the development of Hashimoto's thyroiditis in two patients.
• The thyroid inflammation may be a direct or indirect consequence of CAR T-cell therapy.
• The precise mechanisms underlying this adverse event require further investigation.

Implications:

• This study highlights a rare but significant immune-related adverse event associated with CAR T-cell therapy.
• Understanding these mechanisms is crucial for managing patients undergoing CAR T-cell therapy.
• Further research is needed to elucidate the relationship between CAR T-cell therapy and autoimmune thyroiditis.