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Published in: Current Hematologic Malignancy Reports 6/2018

01-12-2018 | CART and Immunotherapy (M Ruella, Section Editor)

Hematopoietic Stem Cell Transplantation in the Era of Engineered Cell Therapy

Authors: Jacob S. Appelbaum, Filippo Milano

Published in: Current Hematologic Malignancy Reports | Issue 6/2018

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Abstract

Purpose of Review

Cellular therapy using T cells modified to express chimeric antigen receptors (CAR-T cells) has had striking success in patients that have failed previous treatment for CD19+ B cell non-Hodgkin lymphoma (NHL), chronic lymphocytic leukemia (CLL), or acute lymphoblastic leukemia (ALL). Curative therapy for this group of diseases has previously been limited to allogeneic hematopoietic cell transplantation HCT (alloHCT). The recent results of CAR-T cell therapy raise the question of how best to integrate CAR-T cell therapy and alloHCT in the care of these patients.

Recent Findings

Within the past 2 years, results from larger trials and increased follow-up of patients treated with CD19 CAR-T cell therapy suggest that some may achieve durable remission without transplant.

Summary

The balance of efficacy and toxicity for CAR-T cell therapy and alloHCT vary by disease type, disease status at the time of treatment, patient characteristics, and the specific therapy employed. There are early signals that subsequent transplantation of patients who have achieved remission with CAR-T may be a potentially viable (though expensive) strategy.
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Metadata
Title
Hematopoietic Stem Cell Transplantation in the Era of Engineered Cell Therapy
Authors
Jacob S. Appelbaum
Filippo Milano
Publication date
01-12-2018
Publisher
Springer US
Published in
Current Hematologic Malignancy Reports / Issue 6/2018
Print ISSN: 1558-8211
Electronic ISSN: 1558-822X
DOI
https://doi.org/10.1007/s11899-018-0476-4

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