CAR-T therapy in solid transplant recipients with post-transplant lymphoproliferative disease: case report and literature review.

Patients with postransplant lymphoproliferative disease (PTLD) who are refractory to rituximab-based regimens have extremely poor prognosis. Data is lacking in the setting of solid organ transplantation (SOT)-related PTLD treated with chimeric antigen receptor T-cell (CAR-T) therapy. Moreover, limit...

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Detalhes bibliográficos
Autores: Hernani, Rafael, Sancho, Asuncion, Amat, Paula, Hernandez-Boluda, Juan Carlos, Perez, Ariadna, Pinana, Jose Luis, Carretero, Carlos, Goterris, Rosa, Gomez, Montse, Saus, Ana, Ferrer, Blanca, Teruel, Ana Isabel, Terol, Maria Jose, Solano, Carlos
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Recursos:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p15905
Acesso em linha:https://incliva.portalinvestigacion.com/publicaciones/15905
Access Level:acceso abierto
Palavra-chave:Chimeric antigen receptor T-cell
Immunosuppression
Postransplant lymphoproliferative disease
Solid organ transplantation
Descrição
Resumo:Patients with postransplant lymphoproliferative disease (PTLD) who are refractory to rituximab-based regimens have extremely poor prognosis. Data is lacking in the setting of solid organ transplantation (SOT)-related PTLD treated with chimeric antigen receptor T-cell (CAR-T) therapy. Moreover, limited information is available on the influence of concomitant immunosuppressive drugs on CAR-T function. Here, we describe the clinical outcome in one PTLD patient and propose a strategy for tailoring immunosuppressive treatment and organ monitoring in patients with kidney allografts after CAR-T infusion. This report also reviews the limited published data in the setting of SOT-related PTLD treated with CAR-T, which appears to be a feasible treatment in this clinical scenario, without severe toxicity and capable of inducing sustained responses. A noteworthy finding is that in most reported cases patients underwent complete or partial discontinuation of immunosuppressive drugs, with only one documented case of allograft rejection.