What is therole of CAR T-cell therapy in the treatment of non-Hodgkin lymphoma/B-cell lymphoma?

Updated: Feb 23, 2021
  • Author: Mohammad Muhsin Chisti, MD, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

In CAR T-cell therapy, the patient's own T-cells are genetically engineered to express a specific CAR; in the case of B-cell lymphoma, this is typically CD19. After a blood sample has been obtained from the patient, the CAR molecule is introduced into the patient’s T cells through viral or nonviral approaches. The cells undergo a brief round of expansion in the laboratory and are then infused back into the patient.

The infused T cells become activated when they recognize the target antigen on the surface of the tumor. Once activated, the T cells undergo massive expansion in the body, proliferating and producing multiple different cytokines. These cytokines improve the T cells’ function, helping them traffic to the tumor site and start killing the tumor cells by expressing cytotoxic molecules (eg, granzymes and perforins).

Cytokine release syndrome is a potentially life-threatening adverse effect of CAR T-cell therapy. Tocilizumab is approved for the treatment of   severe or life-threatening cytokine release syndrome induced by CAR T-cell therapy. [17]

For full discussion of CAR T-cell therapy, see Cancer Immunotherapy with Chimeric Antigen Receptor (CAR) T-Cells


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