Disappearance of antiphospholipid antibodies after anti-CD19 chimeric antigen receptor T-cell therapy of B-cell lymphoma in a patient with systemic lupus erythematosus and antiphospholipid syndrome
Eleonora Friedberg, Philipp Wohlfarth, Ana Iris Schiefer, Cathrin Skrabs, Winfried F. Pickl, Nina Worel, Philipp B. Staber, Ulrich Jäger, Cihan Ay
Abstract
Antiphospholipid syndrome is an autoimmune disorder characterized by the development of spontaneous venous, arterial, or microvascular thrombosis and/or pregnancy-related complications (eg, miscarriages, fetal loss) in the presence of persistent antiphospholipid (aPL) antibodies. Current state-of-the-art treatment consists of indefinite anticoagulation with vitamin K antagonists to prevent recurrence of thrombotic events. This, however, represents only a symptom-control-oriented treatment approach. To date, no curative option eradicating aPL antibodies permanently or addressing the underlying pathomechanism has been established. Here, we report the case of a woman with systemic lupus erythematosus and antiphospholipid syndrome with triple aPL antibody-positivity who developed recurrent deep venous thrombosis. After receiving chimeric antigen receptor T-cell therapy for aggressive B-cell lymphoma, sustained eradication of all 3 aPL antibody subtypes was observed, suggesting a promising role of immunotherapies targeting anti-CD19 for the treatment of prothrombotic autoimmune disorders.