CAR-T cell-based dual therapy successfully tested in refractory myasthenia gravis

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 lymphocytesC’est une catégorie de globules blancs. Ces petites cellules au noyau arrondi et volumineux sont impliquées dans les aspects spécifiques des réactions immunitaires. Il existe deux catégories de lymphocytes les lymphocytes B (qui secrètent les anticorps) et les lymphocytes T. 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.

Bispecific BCMA/CD19 targeted CAR-T cell therapy forces sustained disappearance of symptoms and anti-acetylcholine receptor antibodies in refractory myasthenia gravis: a case report. Zhang Y, Liu D, Zhang Z et al. J Neurol. 2024 Apr 11.