• Juan Du and Yonghong Zhang.
• Tianjin Medical University, Tianjin, 300070, China.
• J. Cancer Res. Clin. Oncol. 2020 Jun 1; 146 (6): 1575-1582.

PurposeBurkitt lymphoma (BL) is one of the most frequent subtypes of non-Hodgkin lymphoma (NHL) in children. Currently, short, intensive chemotherapy is used internationally and has greatly improved survival in children with BL. However, 5-10% of patients suffer recurrence after intensive chemotherapy, and the prognosis of these patients remains poor. The overall survival rate is only approximately 10%. Innovative therapies are needed to attain a higher rate of remission, such as immunotherapy for relapsed refractory (r/r) BL patients.MethodsAn 8-year-old boy with BL was studied. He suffered a relapse after treatment with standard chemotherapy. Then, we treated this patient using autologous chimeric antigen receptor T-cell (CAR-T) therapies, sequentially targeting antigens CD19, CD22, and CD20. A review of the current literature on CAR-T treatment for lymphoma is presented.ResultsThe patient had no discernible response to anti-CD19 CAR-T treatment and exhibited progressive disease (PD). Following CD-22-directed CAR-T treatment, the patient underwent a partial remission (PR), but unfortunately a relapse rapidly occurred. Finally, after administering the anti-CD20 CAR-T cell therapy, the child went into complete remission (CR). The young boy has currently achieved 16-month event-free survival (EFS) so far. During administration of the CD19 and CD20 CAR-T cells, the patient appeared to experience mild (Grade I) cytokine release syndrome (CRS). However, during the CD22 CAR-T therapy, he appeared to experience grade III CRS.ConclusionAutologous anti-CD19, anti-CD22, and anti-CD20 CAR-T cell therapies targeting multiple tumor antigens could be an innovative and sound treatment for children with r/r BL, provided that they are closely monitored during treatment.

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