Anti-CD19 CAR-T therapy for EBV-negative posttransplantation lymphoproliferative disease—a single center case series

Efrat Luttwak*, David Hagin, Chava Perry, Ofir Wolach, Gilad Itchaki, Odelia Amit, Yael Bar-On, Tal Freund, Sigi Kay, Rinat Eshel, Irit Avivi, Ron Ram

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Posttransplantation lymphoproliferative disease (PTLD) is a potentially fatal disorder arising after solid organ or hematopoietic cell transplantation. Survival rates of PTLD with diffuse large B-cell lymphoma (DLBCL) phenotype have improved due to the introduction of rituximab, however, reports on curative management of refractory PTLD are scarce. Here, we describe successful management of three patients with refractory EBV-negative PTLD with chimeric antigen receptor T-cell (CAR-T) therapy. All patients continued calcineurin inhibitors throughout the whole course of treatment. T-cell immunophenotyping was performed on both the apheresed cells and CAR-T product to investigate the T-cell compartment subpopulations. All three patients responded to a single infusion of tisagenlecleucel and two of them achieved CR. Toxicity profile was similar to other patients with non-PTLD DLBCL treated with CAR-T. No transplanted graft dysfunction was observed during the course of therapy. To our knowledge, this is the first report demonstrating that patients with EBV-negative refractory PTLD may benefit from CAR-T therapy, similarly to other patients with relapse/refractory DLBCL. A larger cohort of patients is needed to further establish proof-of-concept.

Original languageEnglish
Pages (from-to)1031-1037
Number of pages7
JournalBone Marrow Transplantation
Volume56
Issue number5
DOIs
StatePublished - May 2021

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