Safety of CAR T-cell therapy in kidney transplant recipients
Omar Mamlouk, Ranjit Nair, Swaminathan P. Iyer, Angelina Edwards, Sattva S. Neelapu, Raphaël Steiner, Sherry Adkins, Misha Hawkins, Neeraj Saini, Kartik Devashish, Paolo Strati, Sreedhar Mandayam, Sairah Ahmed
Abstract
Recipients of solid organ transplant are at increased risk to develop posttransplant lymphoproliferative disorder (PTLD). However, only 30% to 40% achieve a durable response. 2,3 Chimeric antigen receptor (CAR) T-cell therapy is a novel treatment with a substantial response (52% to 82%) in patients with relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL), 4,5 but its safety and efficacy in PTLD is unknown. Two CAR T-cell therapy products, axi-cel and tisagenlecleucel, are currently approved for r/r DLBCL and both are derived from autologous T cells. Because solid organ transplant recipients are on long-term immunosuppressive therapy to prevent allograft rejection, there is concern about the feasibility of generating an effective autologous CAR T-cell product. Here, we report the safety and efficacy of autologous CAR T-cell therapy in 3 patients with r/r DLBCL and kidney allograft who were treated with axi-cel in 2019 to 2020.