{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T16:58:38Z","timestamp":1781110718938,"version":"3.54.1"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T00:00:00Z","timestamp":1701993600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Follicular lymphoma (FL), a common indolent B-cell lymphoma, has the potential to transform into an aggressive lymphoma, such as diffuse large B-cell lymphoma (DLBCL). The outcome of patients with transformed follicular lymphoma (tFL) is poor, especially in patients with transformed lymphoma after chemotherapy and patients with progression within 24 months (POD24). Chimeric antigen receptor (CAR) T-cell therapy combined with autologous stem cell transplantation (ASCT) has promising antitumor efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>Here, we described a 39-year-old male patient who was initially diagnosed with FL that transformed into DLBCL with POD24, CD20 negativity, <jats:italic>TP53<\/jats:italic> mutation, and a bulky mass after 3 lines of therapy, all of which were adverse prognostic factors. We applied a combination approach: CD19 CAR T-cell infusion following ASCT. Ibrutinib was administered continuously to enhance efficacy, DHAP was administered as a salvage chemotherapy, and ICE was administered as a bridging regimen. The patient underwent BEAM conditioning on days -7~ -1, a total of 3.8 \u00d7 10<jats:sup>6\/<\/jats:sup>kg CD34<jats:sup>+<\/jats:sup> stem cells were infused on days 01~02, and a total of 10<jats:sup>8<\/jats:sup> CAR T cells (relmacabtagene autoleucel, relma-cel, JWCAR029) were infused on day 03. The patient experienced grade 2 cytokine release syndrome (CRS), manifesting as fever and hypotension according to institutional standards. There was no immune effector cell-associated neurotoxicity syndrome (ICANS) after CAR T-cell infusion. Finally, the patient achieved CMR at +1 month, which has been maintained without any other adverse effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case highlights the amazing efficacy of CD19 CAR T-cell therapy following ASCT for R\/R tFL, thus providing new insight on therapeutic strategies for the future.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2023.1307242","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T09:48:15Z","timestamp":1702288095000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Case Report: CD19 CAR T-cell therapy following autologous stem cell transplantation: a successful treatment for R\/R CD20-negative transformed follicular lymphoma with TP53 mutation"],"prefix":"10.3389","volume":"14","author":[{"given":"Jinjing","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dali","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Miao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenghua","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heyang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojing","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3324\/haematol.2021.278766","article-title":"Time for an individualized approach to first-line management of follicular lymphoma","volume":"107","author":"Cartron","year":"2022","journal-title":"Haematologica"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1182\/hematology.2020000115","article-title":"Transformed lymphoma: what should I do now","volume":"2020","author":"Smith","year":"2020","journal-title":"Hematol Am Soc Hematol Educ Program"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2022.09.003","article-title":"Risk factors for and outcomes of follicular lymphoma histological transformation at first progression in the GALLIUM study","volume":"23","author":"Casulo","year":"2023","journal-title":"Clin lymphoma myeloma leukemia"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/onco.13846","article-title":"Single-center analysis of characteristics and outcomes of de novo, concurrent, and transformed diffuse large B-cell lymphoma","volume":"26","author":"Desai","year":"2021","journal-title":"oncologist"},{"key":"B5","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1038\/s41392-022-00924-0","article-title":"Outcome of aggressive B-cell lymphoma with TP53 alterations administered with CAR T-cell cocktail alone or in combination with ASCT","volume":"7","author":"Wei","year":"2022","journal-title":"Signal transduction targeted Ther"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002197","article-title":"Histological transformation and progression in follicular lymphoma: A clonal evolution study","volume":"13","author":"Kridel","year":"2016","journal-title":"PloS Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1111\/bjh.14831","article-title":"Risk of, and survival following, histological transformation in follicular lymphoma in the rituximab era. 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