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Biol Blood Marrow Transplant. 2019 Aug 22. pii: S1083-8791(19)30529-4. doi: 10.1016/j.bbmt.2019.08.015. [Epub ahead of print]

Use of Chimeric Antigen Receptor T Cell Therapy in Clinical Practice for Relapsed/Refractory Aggressive B Cell Non-Hodgkin Lymphoma: An Expert Panel Opinion from the American Society for Transplantation and Cellular Therapy.

Author information

1
Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Hematologic Malignancies and Bone Marrow Transplantation Program, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland.
2
Division of Clinical Research, Fred Hutchinson Cancer Research Center and Department of Medicine, University of Washington, Seattle, Washington.
3
Department of Hematology and Oncology, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas.
4
Lymphoma Program, Abramson Cancer Center at University of Pennsylvania, Philadelphia, Pennsylvania.
5
Division of Hematology, Mayo Clinic, Rochester, Minnesota; Oncology Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
6
Department of Lymphoma and Myeloma, University of Texas MD Anderson Cancer Center, Houston, Texas.
7
Division of Hematology and Medical Oncology, Vanderbilt University Medical Center, Nashville, Tennessee.
8
The Chaim Sheba Medical Center, Tel-Hashomer, Affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
9
Blood and Marrow Transplant and Cellular Immunotherapy Program, Moffitt Cancer Center, Tampa, Florida.
10
Immune Effector Cell Therapy Program, Dana-Farber Cancer Institute, Boston, Massachusetts.
11
Division of Hematology, Mayo Clinic, Rochester, Minnesota.
12
National Marrow Donor Program and Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota.
13
Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota.
14
Center for Cancer and Immunology Research, Children's National Health System, Washington, DC.
15
Division of Clinical Research, Fred Hutchinson Cancer Research Center and Department of Medicine, University of Washington, Seattle, Washington; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.
16
Division of Oncology, Washington University School of Medicine, St Louis, Missouri.
17
Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
18
Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas.
19
Division of Clinical Research, Fred Hutchinson Cancer Research Center and Department of Medicine, University of Washington, Seattle, Washington; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
20
Division of Transplantation and Cellular Therapy, Sylvester Comprehensive Cancer Center, Miami, Florida.
21
Department of General Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
22
Division of Hematology and Oncology, Case Western Reserve University, Cleveland, Ohio.
23
Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas.
24
Hematology and Cellular Therapy Department, Saint-Antoine Hospital, AP-HP, Sorbonne University, INSERM UMRs 938, Paris, France.
25
Division of Blood and Marrow Transplantation, Stanford University, Stanford, California.
26
Graft-versus-Host and Late Effects Section, National Cancer Institute, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland.
27
Division of Hematology-Oncology and Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, Florida. Electronic address: Mohamed@mayo.edu.
28
Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York. Electronic address: peralesm@mskcc.org.
29
Division of Hematology, Mayo Clinic, Rochester, Minnesota. Electronic address: Lin.Yi@mayo.edu.

Abstract

Axicabtagene ciloleucel (YESCARTA; Kite Pharma, a Gilead Company, Los Angeles CA) and tisagenlecleucel (KYMRIAH; Novartis Pharmaceuticals Corp., Basel, Switzerland) are two CD19-directed chimeric antigen receptor (CAR) T cell products currently approved by the US Food and Drug Administration; the European Medicines Agency; Health Canada; Ministry of Health, Labor and Welfare (Japan); and Therapeutic Goods Administration (Australia) for treatment of specific subtypes of relapsed/refractory aggressive B cell non-Hodgkin lymphoma (NHL). Although this approval has been transformative in the use of cellular immunotherapy in lymphoma, there are concerns regarding appropriate use of this novel therapy and of short- and long-term toxicities. To address these issues, representatives of the American Society of Transplantation and Cellular Therapy convened to recognize and address key issues surrounding the clinical application of CD19 CAR T cell therapy in B cell lymphomas, in collaboration with worldwide experts. The aim of this article is to provide consensus opinion from experts in the fields of hematopoietic cell transplantation, cellular immunotherapy, and lymphoma regarding key clinical questions pertinent to the use of CD19 CAR T cell products for the treatment of NHL. As the clinical practice using CAR T cells grows worldwide, we anticipate that this guidance will be relevant for hematology/oncology physicians who care for patients with lymphomas.

KEYWORDS:

Chimeric antigen receptor T cell therapy; Diffuse large B cell lymphoma; Non-Hodgkin lymphoma

PMID:
31446199
DOI:
10.1016/j.bbmt.2019.08.015

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