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Review
. 2017 Jan 31;10(1):35.
doi: 10.1186/s13045-017-0405-3.

Allogeneic CD19-CAR-T cell infusion after allogeneic hematopoietic stem cell transplantation in B cell malignancies

Jun Liu  1 , Jiang F Zhong  2 , Xi Zhang  1 , Cheng Zhang  3
Affiliations
Review

Allogeneic CD19-CAR-T cell infusion after allogeneic hematopoietic stem cell transplantation in B cell malignancies

Jun Liu et al. J Hematol Oncol. .

Abstract

Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is considered the cornerstone in treatment of hematological malignancies. However, relapse of the hematological disease after allo-HSCT remains a challenge and is associated with poor long-term survival. Chimeric antigen receptor redirected T cells (CAR-T cells) can lead to disease remission in patients with relapsed/refractory hematological malignancies. However, the therapeutic window for infusion of CAR-T cells post allo-HSCT and its efficacy are debatable.

Main body: In this review, we first discuss the use of CAR-T cells for relapsed cases after allo-HSCT. We then review the toxicities and the occurrence of graft-versus-host disease in relapsed patients who received CAR-T cells post allo-HSCT. Finally, we review clinical trial registrations and the therapeutic time window for infusion of CAR-T cells post allo-HSCT.

Conclusions: The treatment of allogeneic CAR-T cells is beneficial for patients with relapsed B cell malignancies after allo-HSCT with low toxicities and complications. However, multicenter clinical trials with larger sample sizes should be performed to select the optimal therapeutic window and confirm its efficacy.

Keywords: Allogeneic hematopoietic stem cell transplantation; CAR-T cells; Lymphoid malignancies.

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Figures

Fig. 1
Fig. 1
Structure of a chimeric antigen receptor (CAR). The CAR comprises three parts: an ectodomain (an antigen-binding region of a monoclonal antibody), a transmembrane domain, and an endodomain (intracellular T cell signaling domains). The lipid bilayer is an integral part of the host cell membrane. The recognition of CAR imparts the ability of a T cell to recognize cell surface molecule; then, engagement of the CAR through its ligand transmits a signal to the intracellular T cell signaling domain
Fig. 2
Fig. 2
The procedure of allogeneic or autologous chimeric antigen receptor (CAR) therapy. T cells are collected from the patients or donors by apheresis, and the T cells are then expanded and genetically modified using one of several approaches. Finally, the CAR-T cells are infused into the patients. APCs antigen-presenting cells
See this image and copyright information in PMC

References

    1. Bhojwani D, Pui CH. Relapsed childhood acute lymphoblastic leukaemia. Lancet Oncol. 2013;14(6):e205–17. doi: 10.1016/S1470-2045(12)70580-6. - DOI - PubMed
    1. Raetz EA, Bhatla T. Where do we stand in the treatment of relapsed acute lymphoblastic leukemia? Hematology Am Soc Hematol Educ Program. 2012;2012:129–36. - PubMed
    1. Forman SJ, Rowe JM. The myth of the second remission of acute leukemia in the adult. Blood. 2013;121(7):1077–82. doi: 10.1182/blood-2012-08-234492. - DOI - PMC - PubMed
    1. Wang YX, Li YH. Efficacy of donor lymphocyte infusion for treating relapsed high-risk leukemia patients after allogeneic hematopoietic stem cell transplantation. Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2015;23(4):982–8. - PubMed
    1. Castagna L, Sarina B, Bramanti S, Perseghin P, Mariotti J, Morabito L. Donor lymphocyte infusion after allogeneic stem cell transplantation. Transfus Apher Sci. 2016;54(3):345–55. doi: 10.1016/j.transci.2016.05.011. - DOI - PubMed

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