Management of Resistant Post-transplant Lymphoproliferative Disorder: CAR-T Is a New Option

This is a review of the therapeutic options for resistant/refractory post-transplant lymphoproliferative disorder (PTLD) in relation to Chimeric antigen receptor-T cell (CAR-T) therapy. Out of a number of possible future strategies for the treatment of PTLD, the following methods were implemented in...

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Bibliographic Details
Published in:Anticancer research 2022-11, Vol.42 (11), p.5181-5186
Main Authors: Styczynski, Jan, Sadlok, Jagoda, Styczynski, Tomasz, Marjanska, Agata, Richert-Przygonska, Monika
Format: Article
Language:English
Subjects:
Antigens
Autografts
CD20 antigen
Chimeric antigen receptors
Epstein-Barr virus
Genetic modification
Immune checkpoint
Lymphatic diseases
Lymphocytes
Lymphocytes B
Lymphocytes T
Patients
PD-1 protein
Posttransplant lymphoproliferative disorders
Receptors
Rituximab
Therapy
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Summary:This is a review of the therapeutic options for resistant/refractory post-transplant lymphoproliferative disorder (PTLD) in relation to Chimeric antigen receptor-T cell (CAR-T) therapy. Out of a number of possible future strategies for the treatment of PTLD, the following methods were implemented in real-world practice: anti-PD1 therapy with checkpoint inhibitor nivolumab, new anti-CD20 ofatumumab, brentuximab vedotin, and zanubrutinib. However, for all these innovative methods, only individual cases of successful treatment of rituximab-resistant Epstein-Barr Virus (EBV)-PTLD patients have been reported so far. CAR-T is an innovative method of treatment, based on genetic modification of receptors of T autologous lymphocytes, creating the "living drug". This therapy can be potent against resistant PTLD, which is a lymphoproliferation of B-lymphocytes. The published real-world data of 17 patients treated with CAR-T for PTLD indicate a success rate of 76.5%. There is development of innovative methods of treatment of resistant/refractory PTLD, with high rate of resolution after CAR-T therapy.
ISSN:0250-7005
1791-7530
DOI:10.21873/anticanres.16024