# CAR-T cell therapy bridging to allogeneic hematopoietic stem cell transplantation for diffuse large B-cell Richter syndrome: a case report and literature review

## TL;DR

This case report explores using CAR-T cell therapy followed by a stem cell transplant to treat a patient with Richter syndrome, a rare and aggressive form of lymphoma.

## Contribution

The study presents a novel treatment approach combining CAR-T therapy and allo-HSCT for Richter syndrome.

## Key findings

- The patient achieved complete remission after CAR-T therapy and allogeneic stem cell transplantation.
- Combination therapies including CAR-T and allo-HSCT may offer a promising treatment strategy for Richter syndrome.
- The case highlights the potential of bridging CAR-T therapy to stem cell transplantation in aggressive lymphomas.

## Abstract

本研究旨在探索嵌合抗原受体T细胞（CAR-T细胞）治疗桥接异基因造血干细胞移植（allo-HSCT）在弥漫大B细胞型Richter综合征患者中的应用，并综述该疾病的诊断、发病机制及治疗进展。本文回顾性分析滨州医学院附属医院1例确诊Richter综合征患者的诊疗过程并进行文献复习。患者为49岁女性，有慢性淋巴细胞白血病（CLL）病史2年余，因颈部右侧包块进行性肿大就诊，最终确诊为CLL转化为弥漫大B细胞淋巴瘤（DLBCL），即Richter综合征。患者先后接受3个周期R-DA-EPOCH联合泽布替尼方案治疗取得部分缓解，之后病情出现进展，调整方案为抗PD-1单抗、抗CD20单抗、XPO1抑制剂及泽布替尼联合治疗1个周期，继而接受自体来源的抗CD19 CAR-T细胞输注并桥接allo-HSCT。患者移植后3个月及8个月评估均显示疾病完全缓解。