CD19-directed chimeric antigen receptor T-cell therapy: what can we learn from the haematologist?

CD19-directed chimeric antigen receptor (CAR) T-cell therapy, originally developed for haematological malignancies, has recently emerged as a promising therapy for patients with autoimmune diseases. By selectively depleting CD19-positive B-cells, this therapy brings a new approach in resetting immun...

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Bibliographic Details
Published in:Lupus science & medicine Vol. 12; no. 1; p. e001157
Main Authors: Kuipers, Maria Theresa, Kersten, Marie José
Format: Journal Article
Language:English
Published: England Lupus Foundation of America 19.01.2025
BMJ Publishing Group LTD
BMJ Publishing Group
Subjects:
Antigens
Antigens, CD19 - immunology
Autoimmune Diseases
Autoimmune Diseases - immunology
Autoimmune Diseases - therapy
B-Lymphocytes - immunology
Biotechnology
Blood cancer
Cells
Clinical trials
Disease
Hematology
Hospitals
Humans
Immune system
Immunotherapy, Adoptive - adverse effects
Immunotherapy, Adoptive - methods
Influenza
Laboratories
Leukemia
Lupus
Lupus Erythematosus, Systemic
Lupus Erythematosus, Systemic - immunology
Lupus Erythematosus, Systemic - therapy
Lymphoma
Multiple sclerosis
Myasthenia gravis
Patients
Receptors, Antigen, T-Cell - immunology
Receptors, Chimeric Antigen - immunology
Remission (Medicine)
Review
Scleroderma
T-Lymphocytes - immunology
China
Hematology
Autoimmune Diseases
Lupus Erythematosus, Systemic
ISSN:2053-8790, 2053-8790
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Description
Summary:CD19-directed chimeric antigen receptor (CAR) T-cell therapy, originally developed for haematological malignancies, has recently emerged as a promising therapy for patients with autoimmune diseases. By selectively depleting CD19-positive B-cells, this therapy brings a new approach in resetting immune dysregulation and potentially providing long-term remission for patients with a refractory disease. Recent reports have highlighted its effectiveness in conditions such as SLE, systemic sclerosis and myositis. However, while these early results are encouraging, questions remain regarding strategies for optimal patient selection and minimising toxicity on the short and long term. The experiences with CD19 CAR T-cell therapy in haematology may offer valuable insights for immunologists and rheumatologists. This article reviews the key principles learnt in haematology, the results and the mechanisms behind its efficacy, toxicities, and the challenges that need to be addressed for its broader application in clinical practice.
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MTK received honoraria from and performed a consulting role for Galapagos. MJK received honoraria from and performed in a consulting/advisory role for BMS/Celgene, Kite, a Gilead Company, Miltenyi Biotec, Novartis and Roche, as well as receiving research funding from Kite, a Gilead Company, Roche, Takeda, and Celgene and travel support from Kite, a Gilead Company, Miltenyi Biotec, Novartis and Roche (all to institutions).
ISSN:2053-8790
2053-8790
DOI:10.1136/lupus-2024-001157