瓦尔登斯特伦巨球蛋白血症 (WM) 的特征是与大量单克隆免疫球蛋白 M (IgM) 蛋白相关的淋巴浆细胞淋巴瘤 (Owen et al., 2003)。常见的体征和症状包括贫血引起的疲劳、淋巴结肿大、肝脾肿大、血小板减少、与高粘度相关的症状和周围神经病变等。尽管 WM 治疗取得了重大进展，但这种类型的惰性淋巴瘤仍然无法治愈，患者的结局多种多样（Ruan et al., 2020）。近年来，针对分化簇 19 (CD19) 的嵌合抗原受体 T (CAR-T) 细胞疗法在 B 细胞恶性肿瘤的治疗中显示出前所未有的缓解率和持久性。在本报告中，我们描述了一个具有挑战性的 WM 病例，该病例涉及多个髓外部位、复发且对化疗、免疫治疗和靶向治疗无效。抗CD19 CAR-T细胞治疗后，肿瘤负荷显着降低，在撰写本报告时患者病情保持稳定。

Waldenström macroglobulinemia (WM) is characterized by lymphoplasmacytic lymphoma associated with large amounts of monoclonal immunoglobulin M (IgM) protein (Owen et al., 2003). Common signs and symptoms include fatigue due to anemia, lymph node enlargement, hepatosplenomegaly, thrombocytopenia, symptoms related to high viscosity, and peripheral neuropathy, among others. Despite significant advances in WM treatment, this type of indolent lymphoma remains incurable, with a wide array of patient outcomes (Ruan et al., 2020). In recent years, chimeric antigen receptor T (CAR-T) cell therapy targeting cluster of differentiation 19 (CD19) has shown unprecedented response rates and durability in the treatment of B-cell malignancies. In this report, we describe a challenging case of WM that involved multiple extramedullary sites, relapsed, and was refractory to chemotherapy, immunotherapy, and targeted therapy. After anti-CD19 CAR-T cell therapy, the tumor burden significantly decreased and the patient's condition remained stable at the writing of this report.