Feasibility and safety of CD19 chimeric antigen receptor T cell treatment for B cell lymphoma relapse after allogeneic hematopoietic stem cell transplantation
Although CD19-directed chimeric antigen receptor (CAR) T cells have been successfully used after a preceding allogeneic stem cell transplant (alloHCT) in patients with acute lymphoblastic leukemia, little is known about the feasibility and outcome of CAR T cell treatment in patients who have been pr...
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| Hauptverfasser: | , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
15 May 2020
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| In: |
Biology of blood and marrow transplantation
Year: 2020, Jahrgang: 26, Heft: 9, Pages: 1575-1580 |
| ISSN: | 1523-6536 |
| DOI: | 10.1016/j.bbmt.2020.04.025 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.bbmt.2020.04.025 Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S1083879120302585 
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| Verfasserangaben: | Maria-Luisa Schubert, Sascha Dietrich, Stephan Stilgenbauer, Anita Schmitt, Petra Pavel, Alexander Kunz, Andrea Bondong, Mandy Wegner, Peter Stadtherr, Susanne Jung, Anthony D. Ho, Carsten Müller-Tidow, Michael Schmitt, Peter Dreger |
| Zusammenfassung: | Although CD19-directed chimeric antigen receptor (CAR) T cells have been successfully used after a preceding allogeneic stem cell transplant (alloHCT) in patients with acute lymphoblastic leukemia, little is known about the feasibility and outcome of CAR T cell treatment in patients who have been previously allotransplanted for lymphoma. In a single-center retrospective analysis, course and outcome of all allografted patients treated with CD19 CAR constructs for B cell lymphoma between October 2018 and November 2019 were studied. CAR therapy consisted either of a third-generation CAR (HD-CAR-1) or of commercially manufactured axicabtagene ciloleucel (axi-cel; Gilead, Santa Monica, U.S.). Altogether, 10 CAR T cell dosings using recipient leukapheresis products were performed in 8 patients: 4 patients (2 mantle cell lymphoma, 2 chronic lymphocytic leukemia) received 6 dosings with HD-CAR-1 and 4 patients (all with diffuse large B cell lymphoma) received 4 dosings with axi-cel. Overall, 6 of 8 patients (75%) responded. CAR treatment was well tolerated with grade ≥ 3 cytokine release syndrome and neurotoxicity each being observed after 1 of 10 dosings. A single patient had moderate chronic graft-versus-host disease. Of note, 3 of 4 patients who received axi-cel had ongoing grade ≥ 3 cytopenia 3 months postdosing, whereas prolonged cytopenia was not observed in 9 alloHCT-naive patients who received axi-cel during the same time period. In conclusion, CAR T cell treatment from recipient-derived leukapheresis products after a prior alloHCT appears to be feasible, effective, and safe in patients with B cell lymphoma. Protracted cytopenia after axi-cel treatment is a matter of concern and requires further exploration. |
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| Beschreibung: | Gesehen am 26.11.2020 |
| Beschreibung: | Online Resource |
| ISSN: | 1523-6536 |
| DOI: | 10.1016/j.bbmt.2020.04.025 |