Diffuse large B-cell lymphoma (DLBCL)-04
Mr. Monger’s Remarkable Early Response: Dual CD19/CD20 CAR-T Therapy Brings New Hope for Relapsed DLBCL
Patient Background
Rodney Charles Monger, a 68-year-old gentleman from overseas, was diagnosed with diffuse large B-cell lymphoma (DLBCL) three years prior. He sought advanced care at Tianjin Cancer Hospital in August 2025. A cervical lymph node biopsy confirmed invasive B-cell lymphoma of germinal center origin. Immunohistochemistry was strongly positive for CD20, CD19, and CD10, with high expression of Bcl-6, Bcl-2 (70%+), and c-MYC (60%+). Genetic testing revealed BCL2 rearrangement by FISH and mutations in EZH2, KMT2D, TNFRSF14, NRAS, and TPMT genes—markers consistent with an aggressive, high-risk profile.
Prior Treatment Journey
In August 2025, Mr. Monger received pola combined with a BTK inhibitor and lenalidomide. He then underwent FC (fludarabine + cyclophosphamide) lymphodepletion chemotherapy. Despite these efforts, his disease remained refractory, prompting the medical team to recommend Bioocus dual-targeting CD19/CD20 CAR-T cell therapy.
On September 8, 2025, Mr. Monger received the infusion of autologous CD19/CD20 CAR-T cells. Remarkably, he experienced no cytokine release syndrome (CRS) and no immune effector cell-associated neurotoxicity syndrome (ICANS)—a smooth post-infusion course that allowed him to remain stable and optimistic from day one.
CAR-T Cell Expansion: Rapid and Robust Peripheral blood monitoring documented impressive CAR-T cell expansion, confirming excellent engraftment and proliferation:
- D4 post-infusion(Sept 12): CAR19+ cells were 0.50% of CD3+ T cells (absolute value 6.04 × 10⁷/L); CAR20+ cells 0.41% (4.96 × 10⁷/L).
- D7(Sept 15): CAR19+ rose to 1.68% (1.40 × 10⁷/L); CAR20+ to 1.63% (1.36 × 10⁷/L).
- D10(Sept 18): CAR19+ reached 43% of CD3+ T cells (absolute value 3.13 × 10⁸/L); CAR20+ reached 32.74% (absolute value 3.26 × 10⁸/L).
Flow cytometry further showed balanced distribution across CD4+ and CD8+ subsets, with strong dual CAR expression. Dynamic monitoring curves illustrated a clear exponential expansion phase, demonstrating that the dual CD19/CD20 design effectively promoted CAR-T persistence and proliferation in vivo.
Current Status and Supportive Care
At the latest follow-up (D10), Mr. Monger continues to do well clinically. He is on a tailored oral medication regimen including acyclovir, compound sulfamethoxazole, orelabrutinib, lenalidomide, and supportive agents, with regular monitoring of blood counts, liver and kidney function, and inflammatory markers as per the discharge plan.
The Bioocus team provided comprehensive, patient-centered support throughout: comfortable accommodation, nutritious meals, transportation assistance, and psychological counseling for Mr. Monger and his family. This holistic approach helped him focus fully on recovery.
A Message of Hope
Mr. Monger’s case exemplifies the transformative potential of Bioocus dual CD19/CD20 CAR-T therapy for patients with relapsed/refractory DLBCL. The rapid, robust expansion of CAR-T cells without severe toxicities highlights the product’s favorable safety profile and potent anti-tumor activity—even in an older patient with high-risk molecular features.
We are proud to support patients like Mr. Monger on their journey back to health. Stories like his reinforce our commitment to delivering innovative, life-changing cell therapies with personalized care.
This case is reported with the patient’s consent. Results may vary; CAR-T outcomes depend on individual disease biology and clinical factors. For more information or to explore treatment options, please visit our CAR-T Therapy for Non-Hodgkin Lymphoma page.
What Is CAR-T Cell Therapy?
CAR-T (Chimeric Antigen Receptor T-cell) therapy is a groundbreaking form of cellular immunotherapy that reprograms a patient's own immune cells to recognize and destroy cancer cells. T-cells are collected from the patient's blood, genetically engineered in a specialized laboratory to express a chimeric antigen receptor targeting specific tumor markers (such as CD19 or CD20 in B-cell lymphomas), expanded to therapeutic quantities, and then reinfused into the patient. Once inside the body, these "living drugs" seek out and eliminate cancer cells expressing the target antigen, offering a highly personalized and precise treatment approach.
For patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) who have exhausted standard chemotherapy options, CAR-T therapy has emerged as a potentially curative alternative, with clinical studies showing durable remission in a meaningful proportion of treated patients.
Why Dual-Targeting CD19/CD20 CAR-T?
Traditional single-target CAR-T therapies (targeting CD19 alone) can sometimes lead to disease relapse when tumor cells lose or downregulate the CD19 antigen — a phenomenon known as antigen escape. Dual-targeting CD19/CD20 CAR-T therapy addresses this challenge by engineering T-cells to recognize two antigens simultaneously, reducing the likelihood of immune escape and potentially improving depth and durability of response, particularly in high-risk, heavily pretreated patients.
Why Choose BIOOCUS for CAR-T Treatment in China?
·Direct Access to Leading CGT Centers: BIOOCUS partners with top-tier hospitals in Beijing and Tianjin, offering access to advanced
CAR-T products often ahead of global availability.
·Personalized Case Coordination: Every international patient is matched with a dedicated medical coordination team that manages
diagnostics review, treatment planning, hospital admission, and communication with referring physicians.
·Comprehensive Patient Support: From visa assistance and accommodation to interpretation services and psychological support,
BIOOCUS manages the full treatment journey so patients and families can focus on recovery.
·Transparent, Evidence-Based Guidance: Our team provides detailed case reviews, expected outcomes, and cost transparency
before any commitment, backed by real patient outcome data such as the case above.
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