Chimeric antigen receptor (CAR) T cells for the treatment of a kidney transplant patient with post-transplant lymphoproliferative disorder (PTLD)

Autor: Kathryn Kline, Wengen Chen, Michael E. Kallen, Rima Koka, Destiny Omili, Xiaoxuan Fan, Thierry Iraguha, Etse Gebru, Nishanthini Dishanthan, Jillian M. Baker, Kenneth A. Dietze, Jean A. Yared, Kim Hankey, Saurabh Dahiya, Silke V. Niederhaus, Kieron Dunleavy, Nancy M. Hardy, Tim Luetkens, Aaron P. Rapoport, Djordje Atanackovic
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Human Vaccines & Immunotherapeutics, Vol 19, Iss 2 (2023)
Druh dokumentu: article
ISSN: 2164-5515
2164-554X
21645515
DOI: 10.1080/21645515.2023.2216116
Popis: Post-transplant lymphoproliferative disorder (PTLD) is a potentially fatal complication following kidney transplantation, and there is a critical and unmet need for PTLD treatments associated with more pronounced and durable responses. To date, reports on the use of CD19-targeted chimeric antigen receptor (CAR) T (CAR-T) cells in patients after solid organ transplant (SOT) have been anecdotal, clinical presentations and outcomes have been heterogenous, and a longitudinal analysis of CAR-T cell expansion and persistence in PTLD patients has not been reported. Our report describes a patient with a history of renal transplant who received CD19-directed CAR-T cell therapy for the treatment of refractory PTLD, diffuse large B cell lymphoma (DLBCL)-type. We show that even with the background of prolonged immunosuppression for SOT, it is possible to generate autologous CAR-T products capable of expansion and persistence in vivo, without evidence of excess T-cell exhaustion. Our data indicate that CAR-T cells generated from a SOT recipient with PTLD can yield deep remissions without increased toxicity or renal allograft dysfunction. Future clinical studies should build on these findings to investigate CAR-T therapy, including longitudinal monitoring of CAR-T phenotype and function, for PTLD in SOT recipients.
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