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Abstract Details

Successful Treatment of Concomitant Myasthenia Gravis and Lambert-Eaton Myasthenic Syndrome with Autologous CD19-targeted CAR-T Cells
Autoimmune Neurology
P4 - Poster Session 4 (11:45 AM-12:45 PM)
14-006
To describe the first successful treatment of concomitant Myasthenia gravis and Lambert-Eaton myasthenic syndrome with autologous CD19-targeted CAR-T cells.
Myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) are autoimmune disorders affecting neuromuscular transmission. Despite advancements, some patients remain challenging to treat.  
Retrospective description of a case with clinical case presentation including video documentation and deep immunophenotyping 

A 33-year-old woman diagnosed with concomitant MG and LEMS in 2019 faced multiple ineffective immunotherapies and a severe course of diseases. Recently, chimeric antigen receptor (CAR)-T lymphocytes targeting CD19 showed promise in addressing autoimmune diseases.  This report details the safe and effective use of anti-CD19 CAR-T cells for the treatment of this patient with combined MG and LEMS. After CAR-T cell therapy, she experienced rapid clinical recovery with regain of full mobility. Deep B cell depletion and normalizing AChR and VGCC (N type) autoantibody levels paralleled the major neurological response. Within two months she moved from wheelchair dependence to bicycling and now at four months has started mountain touring. 
In conclusion, this report highlights the potential for an anti-CD19 CAR-T cell approach in achieving autoimmune resetting for the treatment of neuroimmunological diseases.
Authors/Disclosures
Jeremias Motte, MD (UK RUB- St. Josef-Hospital)
PRESENTER 		The institution of Prof. Motte has received research support from Ruhr-Univerity Bochum.
Melissa Sgodzai Melissa Sgodzai has nothing to disclose.
Christiane Schneider-Gold No disclosure on file
Dominic Borie (Kyverna Therapeutics Inc.) Dominic Borie has received personal compensation for serving as an employee of Kyverna Therapeutics. Dominic Borie has received personal compensation in the range of $100,000-$499,999 for serving as an officer or member of the Board of Directors for Kyverna Therapeutics. Dominic Borie has stock in Kyverna.
Tobias Hegelmaier Tobias Hegelmaier has nothing to disclose.
Aiden Haghikia, MD (Hannover Medical School) Dr. Haghikia has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck Serono. The institution of Dr. Haghikia has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Haghikia has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Galapagos. Dr. Haghikia has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck Serono. Dr. Haghikia has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Kyverna. Dr. Haghikia has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Roche. Dr. Haghikia has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Haghikia has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Haghikia has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer. Dr. Haghikia has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Neuraxpharm. Dr. Haghikia has received personal compensation in the range of $500-$4,999 for serving as a speaker with Biogen. Dr. Haghikia has received personal compensation in the range of $500-$4,999 for serving as a speaker with Sanofi. Dr. Haghikia has received personal compensation in the range of $500-$4,999 for serving as a speaker with Novartis. Dr. Haghikia has received personal compensation in the range of $500-$4,999 for serving as a speaker with Merck Serono. Dr. Haghikia has received personal compensation in the range of $500-$4,999 for serving as a speaker with Celgene.
Dimitrios Mougiakakos (Otto von Guericke University Magdeburg) Dimitrios Mougiakakos has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kyverna Therapeutics. Dimitrios Mougiakakos has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Interius Bio. Dimitrios Mougiakakos has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AvenCell. Dimitrios Mougiakakos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Beigene. Dimitrios Mougiakakos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kite/Gilead. Dimitrios Mougiakakos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BMS. Dimitrios Mougiakakos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dimitrios Mougiakakos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Astra Zeneca. Dimitrios Mougiakakos has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dimitrios Mougiakakos has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie.
Roland Schroers Roland Schroers has received personal compensation in the range of $500-$4,999 for serving as a Consultant for KYVERNA.
Ralf Gold, MD (Neurologische Universitaetsklinik) Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen . Dr. Gold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer Vital. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai Pharamaceuticals. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for SAGE Publishers. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Novartis. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Biogen. The institution of Dr. Gold has received research support from Novartis. The institution of Dr. Gold has received research support from Biogen.