Graft‐<i>versus</i>‐host disease induced by tisagenlecleucel in patients after allogeneic stem cell transplantation

Gabelli, Maria; Marks, David I.; Sharplin, Kirsty; Lazareva, Arina; Mullanfiroze, Khushnuma; Farish, Susan; Burridge, Saskia; Velangi, Mark; Rampling, Dyanne; Mozayani, Behrang; Chiesa, Robert; Lucchini, Giovanna; Samarasinghe, Sujith; Bartram, Jack; Ghorashian, Sara

doi:10.1111/bjh.17737

Cited by 7 publications

(3 citation statements)

References 15 publications

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“…However, patients undergoing CAR-T cell therapy after previous allogeneic HCT may have a low risk of developing new onset or worsening GVHD from "pseudoallogeneic" donor T cells collected from the recipient. 40,128,129 Such cases should be treated in accordance with standard GVHD management guidelines, although the impact of immunosuppression should be carefully considered for diseases such as B-ALL where CAR-T cell persistence is thought to be important for maintaining remission. 130 Given that CAR-T cell therapy achieves durable remissions in 30%-50% of infused patients and is rapidly expanding into new disease indications and earlier lines of treatment, the number of long-term survivors after CAR-T cell therapy is anticipated to dramatically increase in the coming years.…”

Section: Organ Dysfunctionmentioning

confidence: 99%

“…Immune‐related events such as rash and pneumonitis have been reported in a small proportion of CAR‐T cell recipients, 40 but there is no definitive evidence linking these events to CAR‐T cells. However, patients undergoing CAR‐T cell therapy after previous allogeneic HCT may have a low risk of developing new onset or worsening GVHD from “pseudo‐allogeneic” donor T cells collected from the recipient 40,128,129 . Such cases should be treated in accordance with standard GVHD management guidelines, although the impact of immunosuppression should be carefully considered for diseases such as B‐ALL where CAR‐T cell persistence is thought to be important for maintaining remission 130 …”

Section: Autoimmunitymentioning

confidence: 99%

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Long‐term survivorship care after CAR‐T cell therapy

Puckrin,

Jamani,

Jimenez‐Zepeda

2023

European J of Haematology

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While cytokine release syndrome and immune effector cell‐associated neurotoxicity syndrome are well‐recognized acute toxicities of chimeric antigen receptor (CAR) T cell therapy, these complications have become increasingly manageable by protocolized treatment algorithms incorporating the early administration of tocilizumab and corticosteroids. As CAR‐T cell therapy expands to new disease indications and the number of long‐term survivors steadily increases, there is growing recognition of the need to appropriately evaluate and manage the late effects of CAR‐T cell therapy, including late‐onset or persistent neurotoxicity, prolonged cytopenias, delayed immune reconstitution and infections, subsequent malignancies, organ dysfunction, psychological distress, and fertility implications. In this review, we provide a practical approach to the long‐term survivorship care of the CAR‐T cell recipient, with a focus on the optimal strategies to address the common and challenging late complications affecting this unique population.

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Section: Organ Dysfunctionmentioning

confidence: 99%

Section: Autoimmunitymentioning

confidence: 99%

Long‐term survivorship care after CAR‐T cell therapy

Puckrin,

Jamani,

Jimenez‐Zepeda

2023

European J of Haematology

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“…Another study by Huang XJ et al reported that among 34 patients who relapsed post-transplant, there were 6 aGVHD cases (17.6%) (2 grade II aGVHD, 3 grade III aGVHD, and 1 grade IV aGVHD) that developed after CD19 CAR-T therapy [62]. In one single-institution study, 3 of 15 (20%) post-transplant patients developed GVHD induced by tisagenlecleucel [63]. In another study, aGVHD was observed in 10 patients (66.67%), including 6 patients with grade I-II of aGVHD and 4 patients with grade III-IV aGVHD [64].…”

Section: Graft-versus-host Disease After Car-t Cell Therapy For B-all...mentioning

confidence: 99%

Efficacy and safety of CD19 CAR-T cell therapy for acute lymphoblastic leukemia patients relapsed after allogeneic hematopoietic stem cell transplantation

Cao

2022

Int J Hematol

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Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective therapy for B-cell acute lymphoblastic leukemia (B-ALL). Although allo-HSCT can be curative for some B-ALL patients, relapse still occurs in some patients following allo-HSCT. Conventional chemotherapies show poor efficacy in B-ALL patients who have relapsed following allo-HSCT. In the past decade, chimeric antigen receptor T-cell (CAR-T) therapy has shown to be efficacious for B-ALL patients. In particular, autologous CD19 CAR-T therapy results in a high remission rate. However, there are challenges in the use of CD19 CAR-T therapy for B-ALL patients who have relapsed following allo-HSCT, including the selection of CAR-T cell source for manufacturing, post-CAR-T graft-versus-host disease (GVHD) risk, maintenance of long-term efficacy after remission through CAR-T therapy, and whether a consolidative second transplant is needed. In this review, we describe the current status of CAR-T therapy for B-ALL patients who have relapsed following allo-HSCT, the advantages and disadvantages of various CAR-T cell sources, the characteristics and management of GVHD following CAR-T therapy, and the risk factors that may affect long-term efficacy. Keywords Allogeneic hematopoietic stem cell transplantation • CD19 chimeric antigen receptor T-cell therapy • B-cell acute lymphoblastic leukemia • Relapse Prevention and management of relapse after allogeneic hematopoietic cell transplantation in hematological malignanciesPei-hua Lu and Kai-yan Liu have contributed equally to this work.

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Tisagenlecleucel

2022

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Graft‐versus‐host disease induced by tisagenlecleucel in patients after allogeneic stem cell transplantation

Cited by 7 publications

References 15 publications

Long‐term survivorship care after CAR‐T cell therapy

Long‐term survivorship care after CAR‐T cell therapy

Efficacy and safety of CD19 CAR-T cell therapy for acute lymphoblastic leukemia patients relapsed after allogeneic hematopoietic stem cell transplantation

Tisagenlecleucel

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