Systemic lupus erythematosus (SLE)-05

Ms. C is a 32-year-old female with a history of being diagnosed with systemic lupus erythematosus (SLE) two years ago. Her primary symptoms included severe nephritis, arthritis, and rashes. Despite receiving multiple immunosuppressive therapies (including glucocorticoids, hydroxychloroquine, and rituximab), her condition remained uncontrolled.

Pre-treatment Condition:

Symptoms: Severe joint pain and swelling, persistent rashes, significant fatigue, and recurrent nephritis flares.

Laboratory Findings:

# SLEDAI-2K score: 16

# Serum anti-double-stranded DNA antibody levels: Elevated above normal range

# Complement C3 and C4 levels: Below normal range

Treatment Process:

1.Patient Selection: Given the ineffectiveness of traditional treatments and the severity of her condition, Ms. C was enrolled in a clinical trial for CAR-T cell therapy.

2.Preparation: Before receiving the CAR-T cell infusion, Ms. C underwent standard chemotherapy conditioning to deplete existing lymphocytes and prepare for the introduction of CAR-T cells.

3.Cell Preparation:

# T cells were isolated from Ms. C’s blood.

# These T cells were genetically engineered in the lab to express chimeric antigen receptors (CAR) targeting CD19 and BCMA antigens.

4.Cell Infusion: After expansion and quality testing, the engineered CAR-T cells were re-infused into Ms. C’s body.

5.Inpatient Monitoring: Ms. C was monitored in the hospital for 25 days post-infusion to observe for potential side effects and assess efficacy.

Treatment Outcomes:

1.Short-term Response:

# Symptom Improvement: Within three weeks post-infusion, Ms. C experienced significant reductions in joint pain and swelling, and her rashes gradually faded.

# Laboratory Results: Two days post-infusion, B cells in Ms. C's blood were completely eradicated, indicating effective targeting by CAR-T cells.

2.Mid-term Evaluation (3 months):

# SLEDAI-2K score: Reduced to 2, indicating substantial disease remission.

# Renal Function: Significant reduction in proteinuria, with nephritis under control.

# Immunological Markers: Decreased levels of anti-double-stranded DNA antibodies, and complement C3 and C4 levels returned to normal.

3.Long-term Outcomes (12 months):

# Sustained Remission: Ms. C maintained drug-free remission for one year with no signs of SLE relapse.

# Safety: Aside from mild cytokine release syndrome (CRS), Ms. C did not experience any severe side effects. Her immune system gradually recovered post-treatment, and re-emerging B cells did not exhibit pathogenicity.

Overall, Ms. C’s condition showed remarkable improvement and sustained remission following CAR-T cell therapy, demonstrating the potential of this treatment for severe and refractory SLE.

CART cell test report：