{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:46:06Z","timestamp":1791996366173,"version":"4.4.0"},"reference-count":11,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Oncol"],"abstract":"<jats:p>Introduction: Primary mediastinal large B-cell lymphoma (PMBCL) is a rare, aggressive lymphoma with limited therapeutic options in the relapsed or refractory setting. Axicabtagene ciloleucel (axi-cel), an anti-CD19 chimeric antigen receptor (CAR) T-cell therapy, has shown promising efficacy; yet treatment decisions remain challenging in patients with rapidly progressive disease and high tumor burden. Case presentation: We report a 29-year-old woman with primary chemotherapy-refractory PMBCL who developed fulminant extranodal disease progression despite radiotherapy and systemic bridging therapy prior to planned axi-cel infusion. Following CAR T-cell therapy, she experienced grade 2 cytokine release syndrome and grade 3 immune effector cell-associated neurotoxicity syndrome, alongside clinical deterioration and radiological findings suggestive of disease progression. Notably, pronounced CAR T-cell expansion preceded biochemical improvement and subsequent radiological tumor regression, consistent with pseudoprogression rather than true treatment failure. Conclusion: Despite initially misleading clinical and imaging findings in the context of suboptimal baseline conditions, the patient achieved a durable complete remission and remains disease-free 23 months post-CAR T-cell therapy, with excellent quality of life. This case highlights the critical importance of recognizing immune-mediated flare phenomena to guide clinical decision-making and avoid premature treatment discontinuation or misclassification of therapeutic failure.<\/jats:p>","DOI":"10.1159\/000553567","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T16:00:49Z","timestamp":1785859249000},"page":"1754-1759","source":"Crossref","is-referenced-by-count":0,"title":["Pseudoprogression after Axi-cel in Primary Refractory PMBCL following Failed Bridging: Case Report and Management Considerations"],"prefix":"10.1159","volume":"19","author":[{"given":"Philip Alan","family":"Speicher","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Noelle","family":"Kronig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7642-2101","authenticated-orcid":false,"given":"Urban","family":"Novak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2021.06.012"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1080\/10428190802108870"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2021004880"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.70033"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-021-00459-7"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023011203"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023011489"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-020-01156-y"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-022-05722-y"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2019.02.008"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2022.2161304"}],"container-title":["Case Reports in Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000553567","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:01:36Z","timestamp":1791993696000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000553567"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000553567","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.33150812","asserted-by":"subject"}]},"ISSN":["1662-6575"],"issn-type":[{"value":"1662-6575","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]}}}