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GVHD after CAR T-cell therapy post allogeneic hematopoietic cell transplantation — successfully treated by extracorporeal photopheresis.

Authors :
Farid, Kiavasch Mohammad Nejad
Bug, Gesine
Schmitt, Anita
Lang, Fabian
Schubert, Maria-Luisa
Haberkorn, Uwe
Müller-Tidow, Carsten
Dreger, Peter
Schmitt, Michael
Source :
Frontiers in Immunology; 2024, p1-9, 9p
Publication Year :
2024

Abstract

Introduction: CAR T-cell therapy is highly effective, but also associated with unique toxicities. Because of the origin of T cells in patients who previously underwent allogeneic hematopoietic cell transplantation (alloHCT), graft-versus-host disease (GVHD) in the post-CAR T-cell setting poses a relevant concern but is only scarcely studied. Potential risk factors and mitigation strategies (from CAR T-cell modifications to clinical management) are yet to be determined. Methods: Sharing our retrospective experience and a mini-review of the literature, our aim is to better understand the frequency and risk of the potential occurrence of GVHD after CAR T cells, which are most likely underestimated. Results: Here, we present a cohort of 11 patients with symptoms suggestive of GVHD out of 25 allografted patients treated with CAR T cells, of whom 3 patients (12%) had GVHD most likely triggered by the preceding CAR T-cell treatment. Severe chronic pulmonary GVHD occurred in a patient after CD19-directed CAR T-cell therapy. Extracorporeal photopheresis (ECP) mediated successful long-term control of GVHD without causing relapse of the underlying disease. Discussion/Conclusion: In conclusion, CD19-directed CAR T-cell therapy seems to be feasible in patients after alloHCT but might comprise the potential risk of triggering GVHD, most likely depending on the T-cell source, donor compatibility, and the specific CAR construct used. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
16643224
Database :
Complementary Index
Journal :
Frontiers in Immunology
Publication Type :
Academic Journal
Accession number :
181250092
Full Text :
https://doi.org/10.3389/fimmu.2024.1500177