Immunology and Hepatitis B virus?
John Albert is a 65-year-old patient treated with antiviral therapy for Hepatitis B virus for 28 months, which he (unwisely) decides to discontinue by himself. A year later he is diagnosed with stage 3 diffuse large B-cell lymphoma. To treat the B-cell lymphoma he undergoes sequential infusion of two specific, third-generation anti-CD19 and anti-CD22 CAR T-cell immunotherapies. Remission of the primary disease is achieved after two and half months. However, one day John takes a turn for the worse and is admitted to hospital with a 7-day history of vomiting, jaundice, itching and dark urine. Initial investigations reveal that John has hepatic encephalopathy and multiple organ dysfunction syndrome. However, the doctors are puzzled by why John is experiencing his symptoms and need the counsel of an expert immunologist. Provide an explanation for why John is in such poor shape?
I think its because the original medication was working: however when he was taken off it and a year later developed the lymphoma the only thing fighting off the HBV was his lymphocytes, but unfortunately due to the CAR-t cell therapy which destroyed a bunch/majority of his B-cells and since he wasnt taking the medication anymore this allowed for the HBV to run rampant causing jaundice and other things associated. Please if im missing things or if im wrong can you clarify.
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