Skip to main content
Top
Published in:

01-01-2025 | Inflammatory Rheumatic Diseases | Review Free for a limited time

Safety and efficacy of CAR-T cell therapy in patients with autoimmune diseases: a systematic review

Authors: Lakshmi Kattamuri, Bhavesh Mohan Lal, Nikhil Vojjala, Mansi Jain, Kunal Sharma, Siddharth Jain, Samer Al Hadidi

Published in: Rheumatology International | Issue 1/2025

Login to get access

Abstract

Chimeric antigen receptor T-cell (CAR-T) therapy has revolutionized the treatment of various hematological malignancies. Recently, CAR-T has been used in refractory auto-immune diseases with initial encouraging results. In this systematic review, we examined the safety and efficacy of CAR-T in patients with refractory auto-immune diseases. PubMed/Medline, EMBASE, Web of Science, and Scopus search revealed 1552 articles, of which 24 were included for the final analysis. 80 patients with autoimmune diseases received CAR-T cell therapy, of which 52 patients had systemic lupus erythematosus, 16 patients had systemic sclerosis, 7 patients had idiopathic inflammatory myopathies, 2 patient had anti-phospholipid antibody syndrome, 2 patients had rheumatoid arthritis, and 1 patient had Sjogren’s disease. 44 patients got CD-19 CAR-T and 36 patients got BCMA/CD-19 compound CAR-T. All the patients achieved an immunosuppression-free state at the last follow-up. Of the 47 patients with follow-up data, 79 patients developed cytokine release syndrome (CRS) and 4 patients developed neurotoxicity. None of the patients had fatal adverse events with CAR-T cell therapy. CAR-T appears to be safe and effective in patients with refractory autoimmune diseases. Future studies are crucial to further validate these findings, explore long-term outcomes, and refine the treatment protocols to enhance efficacy and safety.
Literature
1.
go back to reference Wang L, Wang FS, Gershwin ME (2015) Human autoimmune diseases: a comprehensive update. J Intern Med 278(4):369–395PubMedCrossRef Wang L, Wang FS, Gershwin ME (2015) Human autoimmune diseases: a comprehensive update. J Intern Med 278(4):369–395PubMedCrossRef
2.
go back to reference Schett G, Mackensen A, Mougiakakos D (2023) CAR T-cell therapy in autoimmune diseases. Lancet 402(10416):2034–2044PubMedCrossRef Schett G, Mackensen A, Mougiakakos D (2023) CAR T-cell therapy in autoimmune diseases. Lancet 402(10416):2034–2044PubMedCrossRef
3.
go back to reference Edwards JC, Szczepanski L, Szechinski J, Filipowicz-Sosnowska A, Emery P, Close DR et al (2004) Efficacy of B-cell-targeted therapy with rituximab in patients with rheumatoid arthritis. N Engl J Med 350(25):2572–2581PubMedCrossRef Edwards JC, Szczepanski L, Szechinski J, Filipowicz-Sosnowska A, Emery P, Close DR et al (2004) Efficacy of B-cell-targeted therapy with rituximab in patients with rheumatoid arthritis. N Engl J Med 350(25):2572–2581PubMedCrossRef
4.
go back to reference Merrill JT, Neuwelt CM, Wallace DJ, Shanahan JC, Latinis KM, Oates JC et al (2010) Efficacy and safety of rituximab in moderately-to-severely active systemic lupus erythematosus: the randomized, double-blind, phase II/III systemic lupus erythematosus evaluation of rituximab trial. Arthritis Rheum 62(1):222–233PubMedPubMedCentralCrossRef Merrill JT, Neuwelt CM, Wallace DJ, Shanahan JC, Latinis KM, Oates JC et al (2010) Efficacy and safety of rituximab in moderately-to-severely active systemic lupus erythematosus: the randomized, double-blind, phase II/III systemic lupus erythematosus evaluation of rituximab trial. Arthritis Rheum 62(1):222–233PubMedPubMedCentralCrossRef
5.
go back to reference Treppo E, Binutti M, Agarinis R, De Vita S, Quartuccio L (2021) Rituximab induction and maintenance in ANCA-associated vasculitis: state of the art and future perspectives. J Clin Med 10:17CrossRef Treppo E, Binutti M, Agarinis R, De Vita S, Quartuccio L (2021) Rituximab induction and maintenance in ANCA-associated vasculitis: state of the art and future perspectives. J Clin Med 10:17CrossRef
6.
go back to reference Oddis CV, Reed AM, Aggarwal R, Rider LG, Ascherman DP, Levesque MC et al (2013) Rituximab in the treatment of refractory adult and juvenile dermatomyositis and adult polymyositis: a randomized, placebo-phase trial. Arthritis Rheum 65(2):314–324PubMedPubMedCentralCrossRef Oddis CV, Reed AM, Aggarwal R, Rider LG, Ascherman DP, Levesque MC et al (2013) Rituximab in the treatment of refractory adult and juvenile dermatomyositis and adult polymyositis: a randomized, placebo-phase trial. Arthritis Rheum 65(2):314–324PubMedPubMedCentralCrossRef
7.
go back to reference Ebata S, Yoshizaki A, Oba K, Kashiwabara K, Ueda K, Uemura Y et al (2021) Safety and efficacy of rituximab in systemic sclerosis (DESIRES): a double-blind, investigator-initiated, randomised, placebo-controlled trial. Lancet Rheumatol 3(7):e489–e497PubMedCrossRef Ebata S, Yoshizaki A, Oba K, Kashiwabara K, Ueda K, Uemura Y et al (2021) Safety and efficacy of rituximab in systemic sclerosis (DESIRES): a double-blind, investigator-initiated, randomised, placebo-controlled trial. Lancet Rheumatol 3(7):e489–e497PubMedCrossRef
8.
go back to reference Terrier B, Amoura Z, Ravaud P, Hachulla E, Jouenne R, Combe B et al (2010) Safety and efficacy of rituximab in systemic lupus erythematosus: results from 136 patients from the French AutoImmunity and Rituximab registry. Arthritis Rheum 62(8):2458–2466PubMedCrossRef Terrier B, Amoura Z, Ravaud P, Hachulla E, Jouenne R, Combe B et al (2010) Safety and efficacy of rituximab in systemic lupus erythematosus: results from 136 patients from the French AutoImmunity and Rituximab registry. Arthritis Rheum 62(8):2458–2466PubMedCrossRef
10.
go back to reference Forsthuber TG, Cimbora DM, Ratchford JN, Katz E, Stüve O (2018) B cell-based therapies in CNS autoimmunity: differentiating CD19 and CD20 as therapeutic targets. Ther Adv Neurol Disord 11:1756286418761697PubMedPubMedCentralCrossRef Forsthuber TG, Cimbora DM, Ratchford JN, Katz E, Stüve O (2018) B cell-based therapies in CNS autoimmunity: differentiating CD19 and CD20 as therapeutic targets. Ther Adv Neurol Disord 11:1756286418761697PubMedPubMedCentralCrossRef
11.
go back to reference Anolik JH, Barnard J, Owen T, Zheng B, Kemshetti S, Looney RJ, Sanz I (2007) Delayed memory B cell recovery in peripheral blood and lymphoid tissue in systemic lupus erythematosus after B cell depletion therapy. Arthritis Rheum 56(9):3044–3056PubMedCrossRef Anolik JH, Barnard J, Owen T, Zheng B, Kemshetti S, Looney RJ, Sanz I (2007) Delayed memory B cell recovery in peripheral blood and lymphoid tissue in systemic lupus erythematosus after B cell depletion therapy. Arthritis Rheum 56(9):3044–3056PubMedCrossRef
12.
go back to reference June CH, O’Connor RS, Kawalekar OU, Ghassemi S, Milone MC (2018) CAR T cell immunotherapy for human cancer. Science 359(6382):1361–1365PubMedCrossRef June CH, O’Connor RS, Kawalekar OU, Ghassemi S, Milone MC (2018) CAR T cell immunotherapy for human cancer. Science 359(6382):1361–1365PubMedCrossRef
13.
go back to reference Al Hadidi S, Heslop HE, Brenner MK, Suzuki M (2024) Bispecific antibodies and autologous chimeric antigen receptor T cell therapies for treatment of hematological malignancies. Mol Ther Al Hadidi S, Heslop HE, Brenner MK, Suzuki M (2024) Bispecific antibodies and autologous chimeric antigen receptor T cell therapies for treatment of hematological malignancies. Mol Ther
14.
go back to reference Kalos M, Levine BL, Porter DL, Katz S, Grupp SA, Bagg A, June CH. T cells with chimeric antigen receptors have potent antitumor effects and can establish memory in patients with advanced leukemia. Science translational medicine. 2011;3(95):95ra73–95ra73. Kalos M, Levine BL, Porter DL, Katz S, Grupp SA, Bagg A, June CH. T cells with chimeric antigen receptors have potent antitumor effects and can establish memory in patients with advanced leukemia. Science translational medicine. 2011;3(95):95ra73–95ra73.
15.
go back to reference Porter DL, Levine BL, Kalos M, Bagg A, June CH (2011) Chimeric antigen receptor-modified T cells in chronic lymphoid leukemia. N Engl J Med 365(8):725–733PubMedPubMedCentralCrossRef Porter DL, Levine BL, Kalos M, Bagg A, June CH (2011) Chimeric antigen receptor-modified T cells in chronic lymphoid leukemia. N Engl J Med 365(8):725–733PubMedPubMedCentralCrossRef
16.
go back to reference Bergmann C, Müller F, Distler JHW, Györfi AH, Völkl S, Aigner M et al (2023) Treatment of a patient with severe systemic sclerosis (SSc) using CD19-targeted CAR T cells. Ann Rheum Dis 82(8):1117–1120PubMedCrossRef Bergmann C, Müller F, Distler JHW, Györfi AH, Völkl S, Aigner M et al (2023) Treatment of a patient with severe systemic sclerosis (SSc) using CD19-targeted CAR T cells. Ann Rheum Dis 82(8):1117–1120PubMedCrossRef
17.
go back to reference Pecher AC, Hensen L, Klein R, Schairer R, Lutz K, Atar D et al (2023) CD19-targeting CAR T cells for myositis and interstitial lung disease associated with antisynthetase syndrome. JAMA 329(24):2154–2162PubMedPubMedCentralCrossRef Pecher AC, Hensen L, Klein R, Schairer R, Lutz K, Atar D et al (2023) CD19-targeting CAR T cells for myositis and interstitial lung disease associated with antisynthetase syndrome. JAMA 329(24):2154–2162PubMedPubMedCentralCrossRef
18.
go back to reference Mougiakakos D, Krönke G, Völkl S, Kretschmann S, Aigner M, Kharboutli S et al (2021) CD19-targeted CAR T cells in refractory systemic lupus erythematosus. N Engl J Med 385(6):567–569PubMedCrossRef Mougiakakos D, Krönke G, Völkl S, Kretschmann S, Aigner M, Kharboutli S et al (2021) CD19-targeted CAR T cells in refractory systemic lupus erythematosus. N Engl J Med 385(6):567–569PubMedCrossRef
19.
go back to reference Müller F, Boeltz S, Knitza J, Aigner M, Völkl S, Kharboutli S et al (2023) CD19-targeted CAR T cells in refractory antisynthetase syndrome. Lancet 401(10379):815–818PubMedCrossRef Müller F, Boeltz S, Knitza J, Aigner M, Völkl S, Kharboutli S et al (2023) CD19-targeted CAR T cells in refractory antisynthetase syndrome. Lancet 401(10379):815–818PubMedCrossRef
20.
go back to reference Müller F, Taubmann J, Bucci L, Wilhelm A, Bergmann C, Völkl S et al (2024) CD19 CAR T-cell therapy in autoimmune disease: a case series with follow-up. N Engl J Med 390(8):687–700PubMedCrossRef Müller F, Taubmann J, Bucci L, Wilhelm A, Bergmann C, Völkl S et al (2024) CD19 CAR T-cell therapy in autoimmune disease: a case series with follow-up. N Engl J Med 390(8):687–700PubMedCrossRef
21.
go back to reference Kansal R, Richardson N, Neeli I, Khawaja S, Chamberlain D, Ghani M et al (2019) Sustained B cell depletion by CD19-targeted CAR T cells is a highly effective treatment for murine lupus. Sci Transl Med 11:482CrossRef Kansal R, Richardson N, Neeli I, Khawaja S, Chamberlain D, Ghani M et al (2019) Sustained B cell depletion by CD19-targeted CAR T cells is a highly effective treatment for murine lupus. Sci Transl Med 11:482CrossRef
22.
go back to reference Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71PubMedPubMedCentralCrossRef Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71PubMedPubMedCentralCrossRef
23.
go back to reference Gasparyan AY, Ayvazyan L, Blackmore H, Kitas GD (2011) Writing a narrative biomedical review: considerations for authors, peer reviewers, and editors. Rheumatol Int 31(11):1409–1417PubMedCrossRef Gasparyan AY, Ayvazyan L, Blackmore H, Kitas GD (2011) Writing a narrative biomedical review: considerations for authors, peer reviewers, and editors. Rheumatol Int 31(11):1409–1417PubMedCrossRef
24.
go back to reference Gladman DD, Ibañez D, Urowitz MB (2002) Systemic lupus erythematosus disease activity index 2000. J Rheumatol 29(2):288–291PubMed Gladman DD, Ibañez D, Urowitz MB (2002) Systemic lupus erythematosus disease activity index 2000. J Rheumatol 29(2):288–291PubMed
25.
go back to reference van Vollenhoven RF, Bertsias G, Doria A, Isenberg D, Morand E, Petri MA et al (2021) 2021 DORIS definition of remission in SLE: final recommendations from an international task force. Lupus Sci Med 8:1 van Vollenhoven RF, Bertsias G, Doria A, Isenberg D, Morand E, Petri MA et al (2021) 2021 DORIS definition of remission in SLE: final recommendations from an international task force. Lupus Sci Med 8:1
26.
go back to reference Fanouriakis A, Kostopoulou M, Andersen J, Aringer M, Arnaud L, Bae S-C et al (2024) EULAR recommendations for the management of systemic lupus erythematosus: 2023 update. Ann Rheum Dis 83(1):15–29PubMedCrossRef Fanouriakis A, Kostopoulou M, Andersen J, Aringer M, Arnaud L, Bae S-C et al (2024) EULAR recommendations for the management of systemic lupus erythematosus: 2023 update. Ann Rheum Dis 83(1):15–29PubMedCrossRef
27.
go back to reference Aggarwal R, Rider LG, Ruperto N, Bayat N, Erman B, Feldman BM et al (2017) 2016 American College of Rheumatology/European League Against Rheumatism criteria for minimal, moderate, and major clinical response in adult dermatomyositis and polymyositis: An International Myositis Assessment and Clinical Studies Group/Paediatric Rheumatology International Trials Organisation Collaborative Initiative. Ann Rheum Dis 76(5):792–801PubMedCrossRef Aggarwal R, Rider LG, Ruperto N, Bayat N, Erman B, Feldman BM et al (2017) 2016 American College of Rheumatology/European League Against Rheumatism criteria for minimal, moderate, and major clinical response in adult dermatomyositis and polymyositis: An International Myositis Assessment and Clinical Studies Group/Paediatric Rheumatology International Trials Organisation Collaborative Initiative. Ann Rheum Dis 76(5):792–801PubMedCrossRef
28.
go back to reference Ross L, Stevens W, Wilson M, Huq M, Strickland G, Walker J et al (2020) Performance of the 2017 EUSTAR activity index in an scleroderma cohort. Clin Rheumatol 39(12):3701–3705PubMedCrossRef Ross L, Stevens W, Wilson M, Huq M, Strickland G, Walker J et al (2020) Performance of the 2017 EUSTAR activity index in an scleroderma cohort. Clin Rheumatol 39(12):3701–3705PubMedCrossRef
29.
go back to reference Steen VD, Medsger TA Jr (2001) Improvement in skin thickening in systemic sclerosis associated with improved survival. Arthritis Rheum 44(12):2828–2835PubMedCrossRef Steen VD, Medsger TA Jr (2001) Improvement in skin thickening in systemic sclerosis associated with improved survival. Arthritis Rheum 44(12):2828–2835PubMedCrossRef
30.
go back to reference Munn Z, Barker TH, Moola S, Tufanaru C, Stern C, McArthur A et al (2020) Methodological quality of case series studies: an introduction to the JBI critical appraisal tool. JBI Evid Synth 18(10):2127–2133PubMed Munn Z, Barker TH, Moola S, Tufanaru C, Stern C, McArthur A et al (2020) Methodological quality of case series studies: an introduction to the JBI critical appraisal tool. JBI Evid Synth 18(10):2127–2133PubMed
31.
go back to reference Zhang W, Feng J, Cinquina A, Wang Q, Xu H, Zhang Q et al (2021) Treatment of Systemic Lupus Erythematosus using BCMA-CD19 Compound CAR. Stem Cell Rev Rep 17(6):2120–2123PubMedPubMedCentralCrossRef Zhang W, Feng J, Cinquina A, Wang Q, Xu H, Zhang Q et al (2021) Treatment of Systemic Lupus Erythematosus using BCMA-CD19 Compound CAR. Stem Cell Rev Rep 17(6):2120–2123PubMedPubMedCentralCrossRef
32.
go back to reference Li M, Zhang Y, Jiang N, Ning C, Wang Q, Xu D et al (2024) Anti–CD19 CAR T cells in refractory immune thrombocytopenia of SLE. N Engl J Med 391(4):376–378PubMedCrossRef Li M, Zhang Y, Jiang N, Ning C, Wang Q, Xu D et al (2024) Anti–CD19 CAR T cells in refractory immune thrombocytopenia of SLE. N Engl J Med 391(4):376–378PubMedCrossRef
33.
go back to reference Yuan Y, He S, Zhang W, Zhang H, Destefano V, Wada M et al (2023) POS1134 novel approach to treat systemic lupus erythematosus, by targeting the “root cause”, B cells and plasma cells, using BCMA-CD19 compound car. Ann Rheum Dis 82(Suppl 1):895CrossRef Yuan Y, He S, Zhang W, Zhang H, Destefano V, Wada M et al (2023) POS1134 novel approach to treat systemic lupus erythematosus, by targeting the “root cause”, B cells and plasma cells, using BCMA-CD19 compound car. Ann Rheum Dis 82(Suppl 1):895CrossRef
34.
go back to reference Feng J, Hu Y, Chang AH, Huang H (2023) CD19/BCMA CAR-T cell therapy for refractory systemic lupus erythematosus: safety and preliminary efficacy data from a phase I clinical study. Blood 142:4835CrossRef Feng J, Hu Y, Chang AH, Huang H (2023) CD19/BCMA CAR-T cell therapy for refractory systemic lupus erythematosus: safety and preliminary efficacy data from a phase I clinical study. Blood 142:4835CrossRef
35.
go back to reference Wang W, He S, Zhang W, Zhang H, DeStefano VM, Wada M et al (2024) BCMA-CD19 compound CAR T cells for systemic lupus erythematosus: a phase 1 open-label clinical trial. Ann Rheum Dis 83(10):1304–1314PubMedCrossRef Wang W, He S, Zhang W, Zhang H, DeStefano VM, Wada M et al (2024) BCMA-CD19 compound CAR T cells for systemic lupus erythematosus: a phase 1 open-label clinical trial. Ann Rheum Dis 83(10):1304–1314PubMedCrossRef
36.
go back to reference Schett G, Bohr D, Mueller F, Hagen M, Bergmann C, Tur C et al (2024) POS0030 safety and preliminary efficacy of CD19 CAR-T cell treatment in rheumatic disease- data from the first part of the phase I/II castle basket study. Ann Rheum Dis 83(Suppl 1):327CrossRef Schett G, Bohr D, Mueller F, Hagen M, Bergmann C, Tur C et al (2024) POS0030 safety and preliminary efficacy of CD19 CAR-T cell treatment in rheumatic disease- data from the first part of the phase I/II castle basket study. Ann Rheum Dis 83(Suppl 1):327CrossRef
37.
go back to reference Amber P, Richard F, Francis K, Justin C, Ranjita S, Ruthee B et al (2024) P95 First two US patients with lupus nephritis (LN) treated with anti-CD19 chimeric antigen receptor (CAR) T-cell therapy: preliminary results from the KYSA-1 phase 1, multicenter study of KYV-101. Lupus Sci Med 11:1 Amber P, Richard F, Francis K, Justin C, Ranjita S, Ruthee B et al (2024) P95 First two US patients with lupus nephritis (LN) treated with anti-CD19 chimeric antigen receptor (CAR) T-cell therapy: preliminary results from the KYSA-1 phase 1, multicenter study of KYV-101. Lupus Sci Med 11:1
38.
go back to reference Auth J, Müller F, Völkl S, Bayerl N, Distler JHW, Tur C, et al. CD19-targeting CAR T-cell therapy in patients with diffuse systemic sclerosis: a case series. Lancet Rheumatol Auth J, Müller F, Völkl S, Bayerl N, Distler JHW, Tur C, et al. CD19-targeting CAR T-cell therapy in patients with diffuse systemic sclerosis: a case series. Lancet Rheumatol
39.
go back to reference Wang X, Wu X, Tan B, Zhu L, Zhang Y, Lin L et al (2024) Allogeneic CD19-targeted CAR-T therapy in patients with severe myositis and systemic sclerosis. Cell 187(18):4890–904.e9PubMedCrossRef Wang X, Wu X, Tan B, Zhu L, Zhang Y, Lin L et al (2024) Allogeneic CD19-targeted CAR-T therapy in patients with severe myositis and systemic sclerosis. Cell 187(18):4890–904.e9PubMedCrossRef
40.
go back to reference Merkt W, Freitag M, Claus M, Kolb P, Falcone V, Röhrich M, et al. Third-generation CD19.CAR-T cell-containing combination therapy in Scl70+ systemic sclerosis. Ann Rheum Dis 2024; 83(4):543–6. Merkt W, Freitag M, Claus M, Kolb P, Falcone V, Röhrich M, et al. Third-generation CD19.CAR-T cell-containing combination therapy in Scl70+ systemic sclerosis. Ann Rheum Dis 2024; 83(4):543–6.
41.
go back to reference Haghikia A, Hegelmaier T, Wolleschak D, Böttcher M, Pappa V, Motte J et al (2024) Clinical efficacy and autoantibody seroconversion with CD19-CAR T cell therapy in a patient with rheumatoid arthritis and coexisting myasthenia gravis. Ann Rheum Dis 83(11):1597–1598PubMedCrossRef Haghikia A, Hegelmaier T, Wolleschak D, Böttcher M, Pappa V, Motte J et al (2024) Clinical efficacy and autoantibody seroconversion with CD19-CAR T cell therapy in a patient with rheumatoid arthritis and coexisting myasthenia gravis. Ann Rheum Dis 83(11):1597–1598PubMedCrossRef
42.
go back to reference Szabo D, Balogh A, Gopcsa L, Giba-Kiss L, Lakatos G, Paksi M et al (2024) Sustained drug-free remission in rheumatoid arthritis associated with diffuse large B-cell lymphoma following tandem CD20-CD19-directed non-cryopreserved CAR-T cell therapy using zamtocabtagene autoleucel. RMD Open 10(4):e004727PubMedPubMedCentralCrossRef Szabo D, Balogh A, Gopcsa L, Giba-Kiss L, Lakatos G, Paksi M et al (2024) Sustained drug-free remission in rheumatoid arthritis associated with diffuse large B-cell lymphoma following tandem CD20-CD19-directed non-cryopreserved CAR-T cell therapy using zamtocabtagene autoleucel. RMD Open 10(4):e004727PubMedPubMedCentralCrossRef
43.
go back to reference Volkov J, Nunez D, Mozaffar T, Stadanlick J, Werner M, Vorndran Z et al (2024) Case study of CD19 CAR T therapy in a subject with immune-mediate necrotizing myopathy treated in the RESET-Myositis phase I/II trial. Mol Ther 32(11):3821–3828PubMedPubMedCentralCrossRef Volkov J, Nunez D, Mozaffar T, Stadanlick J, Werner M, Vorndran Z et al (2024) Case study of CD19 CAR T therapy in a subject with immune-mediate necrotizing myopathy treated in the RESET-Myositis phase I/II trial. Mol Ther 32(11):3821–3828PubMedPubMedCentralCrossRef
44.
go back to reference Schmelz JL, Navsaria L, Goswamy R, Chuang HH, Miranda RN, Lee HJ (2020) Chimeric antigen receptor T-cell therapy’s role in antiphospholipid syndrome: a case report. Br J Haematol 188(3):e5–e8PubMedCrossRef Schmelz JL, Navsaria L, Goswamy R, Chuang HH, Miranda RN, Lee HJ (2020) Chimeric antigen receptor T-cell therapy’s role in antiphospholipid syndrome: a case report. Br J Haematol 188(3):e5–e8PubMedCrossRef
45.
go back to reference Friedberg E, Wohlfarth P, Schiefer AI, Skrabs C, Pickl WF, Worel N, et al. (2024) Disappearance of antiphospholipid antibodies after anti-CD19 chimeric antigen receptor T-cell therapy of B-cell lymphoma in a patient with systemic lupus erythematosus and antiphospholipid syndrome. J Thromb Haemost Friedberg E, Wohlfarth P, Schiefer AI, Skrabs C, Pickl WF, Worel N, et al. (2024) Disappearance of antiphospholipid antibodies after anti-CD19 chimeric antigen receptor T-cell therapy of B-cell lymphoma in a patient with systemic lupus erythematosus and antiphospholipid syndrome. J Thromb Haemost
46.
go back to reference Sheng L, Zhang Y, Song Q, Jiang X, Cao W, Li L et al (2023) Concurrent remission of lymphoma and Sjögren’s disease following anti-CD19 chimeric antigen receptor-T cell therapy for diffuse large B-cell lymphoma: a case report. Front Immunol 14:1298815PubMedPubMedCentralCrossRef Sheng L, Zhang Y, Song Q, Jiang X, Cao W, Li L et al (2023) Concurrent remission of lymphoma and Sjögren’s disease following anti-CD19 chimeric antigen receptor-T cell therapy for diffuse large B-cell lymphoma: a case report. Front Immunol 14:1298815PubMedPubMedCentralCrossRef
47.
go back to reference Furie R, Petri M, Zamani O, Cervera R, Wallace DJ, Tegzová D et al (2011) A phase III, randomized, placebo-controlled study of belimumab, a monoclonal antibody that inhibits B lymphocyte stimulator, in patients with systemic lupus erythematosus. Arthritis Rheum 63(12):3918–3930PubMedPubMedCentralCrossRef Furie R, Petri M, Zamani O, Cervera R, Wallace DJ, Tegzová D et al (2011) A phase III, randomized, placebo-controlled study of belimumab, a monoclonal antibody that inhibits B lymphocyte stimulator, in patients with systemic lupus erythematosus. Arthritis Rheum 63(12):3918–3930PubMedPubMedCentralCrossRef
48.
go back to reference Jin X, Xu Q, Pu C, Zhu K, Lu C, Jiang Y et al (2021) Therapeutic efficacy of anti-CD19 CAR-T cells in a mouse model of systemic lupus erythematosus. Cell Mol Immunol 18(8):1896–1903PubMedCrossRef Jin X, Xu Q, Pu C, Zhu K, Lu C, Jiang Y et al (2021) Therapeutic efficacy of anti-CD19 CAR-T cells in a mouse model of systemic lupus erythematosus. Cell Mol Immunol 18(8):1896–1903PubMedCrossRef
49.
go back to reference Locke FL, Ghobadi A, Jacobson CA, Miklos DB, Lekakis LJ, Oluwole OO et al (2019) Long-term safety and activity of axicabtagene ciloleucel in refractory large B-cell lymphoma (ZUMA-1): a single-arm, multicentre, phase 1–2 trial. Lancet Oncol 20(1):31–42PubMedCrossRef Locke FL, Ghobadi A, Jacobson CA, Miklos DB, Lekakis LJ, Oluwole OO et al (2019) Long-term safety and activity of axicabtagene ciloleucel in refractory large B-cell lymphoma (ZUMA-1): a single-arm, multicentre, phase 1–2 trial. Lancet Oncol 20(1):31–42PubMedCrossRef
50.
go back to reference Oluwole OO, Bouabdallah K, Muñoz J, De Guibert S, Vose JM, Bartlett NL et al (2021) Prophylactic corticosteroid use in patients receiving axicabtagene ciloleucel for large B-cell lymphoma. Br J Haematol 194(4):690–700PubMedPubMedCentralCrossRef Oluwole OO, Bouabdallah K, Muñoz J, De Guibert S, Vose JM, Bartlett NL et al (2021) Prophylactic corticosteroid use in patients receiving axicabtagene ciloleucel for large B-cell lymphoma. Br J Haematol 194(4):690–700PubMedPubMedCentralCrossRef
51.
go back to reference Jacobson CA, Chavez JC, Sehgal AR, William BM, Munoz J, Salles G et al (2022) Axicabtagene ciloleucel in relapsed or refractory indolent non-Hodgkin lymphoma (ZUMA-5): a single-arm, multicentre, phase 2 trial. Lancet Oncol 23(1):91–103PubMedCrossRef Jacobson CA, Chavez JC, Sehgal AR, William BM, Munoz J, Salles G et al (2022) Axicabtagene ciloleucel in relapsed or refractory indolent non-Hodgkin lymphoma (ZUMA-5): a single-arm, multicentre, phase 2 trial. Lancet Oncol 23(1):91–103PubMedCrossRef
52.
go back to reference Locke FL, Miklos DB, Jacobson CA, Perales M-A, Kersten M-J, Oluwole OO et al (2022) Axicabtagene Ciloleucel as Second-Line Therapy for Large B-Cell Lymphoma. N Engl J Med 386(7):640–654PubMedCrossRef Locke FL, Miklos DB, Jacobson CA, Perales M-A, Kersten M-J, Oluwole OO et al (2022) Axicabtagene Ciloleucel as Second-Line Therapy for Large B-Cell Lymphoma. N Engl J Med 386(7):640–654PubMedCrossRef
53.
go back to reference Wang M, Munoz J, Goy A, Locke FL, Jacobson CA, Hill BT et al (2020) KTE-X19 CAR T-cell therapy in relapsed or refractory mantle-cell lymphoma. N Engl J Med 382(14):1331–1342PubMedPubMedCentralCrossRef Wang M, Munoz J, Goy A, Locke FL, Jacobson CA, Hill BT et al (2020) KTE-X19 CAR T-cell therapy in relapsed or refractory mantle-cell lymphoma. N Engl J Med 382(14):1331–1342PubMedPubMedCentralCrossRef
54.
go back to reference Wang M, Munoz J, Goy A, Locke FL, Jacobson CA, Hill BT et al (2023) Three-year follow-up of KTE-X19 in patients with relapsed/refractory mantle cell lymphoma, including high-risk subgroups, in the ZUMA-2 study. J Clin Oncol 41(3):555–567PubMedCrossRef Wang M, Munoz J, Goy A, Locke FL, Jacobson CA, Hill BT et al (2023) Three-year follow-up of KTE-X19 in patients with relapsed/refractory mantle cell lymphoma, including high-risk subgroups, in the ZUMA-2 study. J Clin Oncol 41(3):555–567PubMedCrossRef
55.
go back to reference Shah BD, Ghobadi A, Oluwole OO, Logan AC, Boissel N, Cassaday RD et al (2021) KTE-X19 for relapsed or refractory adult B-cell acute lymphoblastic leukaemia: phase 2 results of the single-arm, open-label, multicentre ZUMA-3 study. Lancet 398(10299):491–502PubMedPubMedCentralCrossRef Shah BD, Ghobadi A, Oluwole OO, Logan AC, Boissel N, Cassaday RD et al (2021) KTE-X19 for relapsed or refractory adult B-cell acute lymphoblastic leukaemia: phase 2 results of the single-arm, open-label, multicentre ZUMA-3 study. Lancet 398(10299):491–502PubMedPubMedCentralCrossRef
56.
go back to reference Jacobson CA, Munoz J, Sun F, Kanters S, Limbrick-Oldfield EH, Spooner C et al (2024) Real-world outcomes with chimeric antigen receptor T cell therapies in large B cell lymphoma: a systematic review and meta-analysis. Transplant Cell Ther 30(1):77CrossRef Jacobson CA, Munoz J, Sun F, Kanters S, Limbrick-Oldfield EH, Spooner C et al (2024) Real-world outcomes with chimeric antigen receptor T cell therapies in large B cell lymphoma: a systematic review and meta-analysis. Transplant Cell Ther 30(1):77CrossRef
57.
go back to reference Wudhikarn K, Perales M-A (2022) Infectious complications, immune reconstitution, and infection prophylaxis after CD19 chimeric antigen receptor T-cell therapy. Bone Marrow Transplant 57(10):1477–1488PubMedPubMedCentralCrossRef Wudhikarn K, Perales M-A (2022) Infectious complications, immune reconstitution, and infection prophylaxis after CD19 chimeric antigen receptor T-cell therapy. Bone Marrow Transplant 57(10):1477–1488PubMedPubMedCentralCrossRef
58.
go back to reference Neelapu SS, Locke FL, Bartlett NL, Lekakis LJ, Miklos DB, Jacobson CA et al (2017) Axicabtagene Ciloleucel CAR T-Cell Therapy in Refractory Large B-Cell Lymphoma. N Engl J Med 377(26):2531–2544PubMedPubMedCentralCrossRef Neelapu SS, Locke FL, Bartlett NL, Lekakis LJ, Miklos DB, Jacobson CA et al (2017) Axicabtagene Ciloleucel CAR T-Cell Therapy in Refractory Large B-Cell Lymphoma. N Engl J Med 377(26):2531–2544PubMedPubMedCentralCrossRef
59.
go back to reference Illei GG, Yarboro CH, Kuroiwa T, Schlimgen R, Austin HA, Tisdale JF et al (2007) Long-term effects of combination treatment with fludarabine and low-dose pulse cyclophosphamide in patients with lupus nephritis. Rheumatology (Oxford) 46(6):952–956PubMedCrossRef Illei GG, Yarboro CH, Kuroiwa T, Schlimgen R, Austin HA, Tisdale JF et al (2007) Long-term effects of combination treatment with fludarabine and low-dose pulse cyclophosphamide in patients with lupus nephritis. Rheumatology (Oxford) 46(6):952–956PubMedCrossRef
60.
go back to reference Adams EM, Pucino F, Yarboro C, Hicks JE, Thornton B, McGarvey C et al (1999) A pilot study: use of fludarabine for refractory dermatomyositis and polymyositis, and examination of endpoint measures. J Rheumatol 26(2):352–360PubMed Adams EM, Pucino F, Yarboro C, Hicks JE, Thornton B, McGarvey C et al (1999) A pilot study: use of fludarabine for refractory dermatomyositis and polymyositis, and examination of endpoint measures. J Rheumatol 26(2):352–360PubMed
61.
go back to reference Levine BL, Pasquini MC, Connolly JE, Porter DL, Gustafson MP, Boelens JJ et al (2024) Unanswered questions following reports of secondary malignancies after CAR-T cell therapy. Nat Med 30(2):338–341PubMedPubMedCentralCrossRef Levine BL, Pasquini MC, Connolly JE, Porter DL, Gustafson MP, Boelens JJ et al (2024) Unanswered questions following reports of secondary malignancies after CAR-T cell therapy. Nat Med 30(2):338–341PubMedPubMedCentralCrossRef
Metadata
Title
Safety and efficacy of CAR-T cell therapy in patients with autoimmune diseases: a systematic review
Authors
Lakshmi Kattamuri
Bhavesh Mohan Lal
Nikhil Vojjala
Mansi Jain
Kunal Sharma
Siddharth Jain
Samer Al Hadidi
Publication date
01-01-2025
Publisher
Springer Berlin Heidelberg
Published in
Rheumatology International / Issue 1/2025
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-024-05772-5