Safety of Axicabtagene Ciloleucel for the Treatment of Relapsed or Refractory Large B-Cell Lymphoma

Effectiveness and Safety of Anti-CD19 Chimeric Antigen Receptor-T Cell Immunotherapy in Patients With Relapsed/Refractory Large B-Cell Lymphoma: A Systematic Review and Meta-Analysis

“…Six studies reported the median PFS ( Locke et al, 2019 ; Abramson et al, 2020 ; Nastoupil et al, 2020 ; Grana et al, 2021 ; Iacoboni et al, 2021 ; Ying et al, 2021 ). The median PFS varied from 3.0 (95%CI: 2.6–4.7) to 8.3 (95%CI: 6.0–15.1) months.…”

The Association Between Glucocorticoid Administration and the Risk of Impaired Efficacy of Axicabtagene Ciloleucel Treatment: A Systematic Review

“…Of note, in Axi-cel therapy, due to the previous tumor-related immunosuppression, lymphodepletion with fludarabine and cyclophosphamide, and the unique toxicity of CAR-T cell, subsequent immune reconstitution, B cell dysplasia and resultant hypogammaglobulinemia, patients are at high risk for infection complications (34)(35)(36)(37)(38). Although there were many other factors, such as CRS, ICANS, tocilizumab use, and bridging therapy may be associated with infection events, glucocorticoid, as an immunosuppressive agent, has been shown to increase the risk of severe and unusual infections (37,39,40). A recent study by Neill et al demonstrated that glucocorticoids use was significantly associated with higher risk of infection, and rapid steroid taper was necessary (41).…”

“…A recent study by Neill et al demonstrated that glucocorticoids use was significantly associated with higher risk of infection, and rapid steroid taper was necessary (41). Infestations following CAR-T therapy which include bacterial, viral, fungal, and protozoal infection are dangerous and even fatal in these patients with weakened immune systems, so it is important to emphasize the importance of immunological monitoring to guide the strategies of antimicrobial prophylaxis for these patients, especially those with glucocorticoids management (34,35,(39)(40)(41)(42)(43). In addition to infection, prolonged use of glucocorticoids may affect mental state, blood pressure, blood sugar and other vital physiological indicators, so for those who could not effectively respond to glucocorticoid in time, alternative strategies such as intrathecal cytotoxic chemotherapy and siltuximab that has a small molecular size than tocilizumab could be considered to avoid increasing glucocorticoid-related side effects (39,44,45).…”

Development of a Radiotracer for PET Imaging of the SNAP Tag

“…In the past few decades, cell therapies have provided a promising way to treat various diseases. − Stem cell therapies and T-cell transfer therapies have progressed to the market or clinical trials for hematopoietic disorders, neurodegenerative diseases, and cancer. − However, only some patients can benefit from cell therapies even with prior screening. Moreover, toxicities, especially cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), of T-cell transfer therapies are difficult to predict. − This uncertainty in prognosis is hard to attenuate because of the limited clinical methods to monitor the in vivo therapeutic functions of these transferred cells over time. Positron emission tomography (PET) cell tracking can provide comprehensive dynamic and spatial information about the therapeutic cell proliferation status and whole-body distribution that blood samples or biopsies cannot and therefore can serve as a potent method for evaluation of cell therapy and response prediction. , …”