Isolated oral CD30+/CD4+ CAR+ T-cell lymphoma in long-term remission after radiotherapy

A Chimeric Antigen Receptor (CAR) positive CD30+/CD4+ T-cell lymphoma (TCL) manifested as a single oral ulceration 22 months after treatment with tisagenlecleucel (tisa-cel), an anti-CD19 CAR T-cell based therapy. TCL showed lentiviral integration in ANKHD1-EIF4EBP3, loss of function of TET2, and NTRK1 copy number gain, suggesting that genetic alterations unrelated to insertional mutagenesis contributed to lymphomagenesis. The patient remains in remission two years after radiotherapy. This is the only CAR+TCL case reported at Ohio State University James Comprehensive Cancer Center, out of 288 patients treated with CAR T-cells.