In a Letter to the Editor, Chinese clinicians report the case of a 64-year-old myasthenic patient who benefited from CAR-T cells targeting both the BCMA and CD19 antigens:
- the patient had had a classic course of refractory myasthenia over the seven years since his diagnosis in 2016,
- a protocol of induced depletion of B lymphocytes preceded the injection of CAR-T cells, which was initially associated with a number of adverse effects, but later proved to be well tolerated,
- clinical parameters (QMG and MG-ADL scores) improved very significantly from day 21 onwards, and a virtual disappearance of anti-RAch autoantibodies was observed within a comparable timeframe,
- to the point where the patient no longer requires any medication at all (after 210 days).
Although involving just one patient, this work is likely to mark a turning point in the management of refractory myasthenias.
