Disappearance of Antiphospholipid Antibodies after anti-CD19 CAR T-Cell Therapy of B-Cell Lymphoma in a Patient with Systemic Lupus Erythematosus and Antiphospholipid Syndrome.

Abstract

Antiphospholipid syndrome is an autoimmune disorder characterized by the development of spontaneous venous, arterial, or microvascular thrombosis and/or pregnancy-related complications (e.g. miscarriages, fetal loss) in the presence of persistent antiphospholipid antibodies (aPL). Current state-of-the-art treatment consists of indefinite anticoagulation with vitamin K antagonists to prevent recurrence of thrombotic events. This, however, only represents a symptom-control oriented treatment approach. Until today, no curative option eradicating aPL 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-positivity who developed recurrent deep veinous thrombosis. After receiving CAR T-Cell therapy for aggressive B-Cell lymphoma, sustained eradication of all three aPL subtypes was observed, suggesting a promising role of immunotherapies targeting anti-CD19 for the treatment of pro-thrombotic autoimmune disorders.