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CAR-T Cell Therapy in Diffuse Large B Cell Lymphoma: Hype and Hope
Patients with non-Hodgkin lymphomas (NHLs) resistant to standard therapies have a dismal prognosis. The outcome is even poorer in patients relapsing after autologous stem cell transplantation. Most of these patients do not qualify for an allogeneic hematopoietic cell transplantation (HCT) due to ref...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746029/ https://www.ncbi.nlm.nih.gov/pubmed/31723824 http://dx.doi.org/10.1097/HS9.0000000000000185 |
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author | Hopfinger, Georg Jäger, Ulrich Worel, Nina |
author_facet | Hopfinger, Georg Jäger, Ulrich Worel, Nina |
author_sort | Hopfinger, Georg |
collection | PubMed |
description | Patients with non-Hodgkin lymphomas (NHLs) resistant to standard therapies have a dismal prognosis. The outcome is even poorer in patients relapsing after autologous stem cell transplantation. Most of these patients do not qualify for an allogeneic hematopoietic cell transplantation (HCT) due to refractory disease, lack of a suitable allogeneic donor, higher age, or cumulative toxicity of previous chemotherapy. Despite patients undergoing allogeneic HCT normally profit from a graft-versus-lymphoma effect, overall survival in patients with NHL after HCT remains short. Therefore, novel treatment modalities are urgently needed. Chimeric antigen receptor (CAR)-T cells, a new class of cellular immunotherapy involving ex vivo genetic modification of T cells to incorporate an engineered CAR have been used in clinical trials. In the majority of studies, B cell malignancies treated with CD19 targeting CAR-T cells have been analyzed. Recently, results from 2 CD19 directed CAR-T cell trials with an increased follow-up of patients led to Food and Drug Administration and European Medicines Agency approval of tisagenlecleucel and axicabtagene ciloleucel. Common adverse events (AEs) include cytokine release syndrome and neurological toxicity, which may require admission to an intensive care unit, B cell aplasia and hemophagocytic lymphohistiocytosis. These AEs are manageable when treated by an appropriately trained team following established algorithm. In this review, we summarize the results of 3 large phase II CD19 CAR-T cell trials and focus on AEs. We also provide a perspective of ongoing activity in this field with the intend to improve the potency of this emerging novel therapy. |
format | Online Article Text |
id | pubmed-6746029 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-67460292019-11-13 CAR-T Cell Therapy in Diffuse Large B Cell Lymphoma: Hype and Hope Hopfinger, Georg Jäger, Ulrich Worel, Nina Hemasphere Review Article Patients with non-Hodgkin lymphomas (NHLs) resistant to standard therapies have a dismal prognosis. The outcome is even poorer in patients relapsing after autologous stem cell transplantation. Most of these patients do not qualify for an allogeneic hematopoietic cell transplantation (HCT) due to refractory disease, lack of a suitable allogeneic donor, higher age, or cumulative toxicity of previous chemotherapy. Despite patients undergoing allogeneic HCT normally profit from a graft-versus-lymphoma effect, overall survival in patients with NHL after HCT remains short. Therefore, novel treatment modalities are urgently needed. Chimeric antigen receptor (CAR)-T cells, a new class of cellular immunotherapy involving ex vivo genetic modification of T cells to incorporate an engineered CAR have been used in clinical trials. In the majority of studies, B cell malignancies treated with CD19 targeting CAR-T cells have been analyzed. Recently, results from 2 CD19 directed CAR-T cell trials with an increased follow-up of patients led to Food and Drug Administration and European Medicines Agency approval of tisagenlecleucel and axicabtagene ciloleucel. Common adverse events (AEs) include cytokine release syndrome and neurological toxicity, which may require admission to an intensive care unit, B cell aplasia and hemophagocytic lymphohistiocytosis. These AEs are manageable when treated by an appropriately trained team following established algorithm. In this review, we summarize the results of 3 large phase II CD19 CAR-T cell trials and focus on AEs. We also provide a perspective of ongoing activity in this field with the intend to improve the potency of this emerging novel therapy. Wolters Kluwer Health 2019-03-08 /pmc/articles/PMC6746029/ /pubmed/31723824 http://dx.doi.org/10.1097/HS9.0000000000000185 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | Review Article Hopfinger, Georg Jäger, Ulrich Worel, Nina CAR-T Cell Therapy in Diffuse Large B Cell Lymphoma: Hype and Hope |
title | CAR-T Cell Therapy in Diffuse Large B Cell Lymphoma: Hype and Hope |
title_full | CAR-T Cell Therapy in Diffuse Large B Cell Lymphoma: Hype and Hope |
title_fullStr | CAR-T Cell Therapy in Diffuse Large B Cell Lymphoma: Hype and Hope |
title_full_unstemmed | CAR-T Cell Therapy in Diffuse Large B Cell Lymphoma: Hype and Hope |
title_short | CAR-T Cell Therapy in Diffuse Large B Cell Lymphoma: Hype and Hope |
title_sort | car-t cell therapy in diffuse large b cell lymphoma: hype and hope |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746029/ https://www.ncbi.nlm.nih.gov/pubmed/31723824 http://dx.doi.org/10.1097/HS9.0000000000000185 |
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