Quality and Cost Outcomes in Chimeric Antigen Receptor T-Cell Immunotherapy in Adult Large B-Cell Cancer Patients from the Vizient Clinical Database

Chimeric Antigen Receptor T-cell (CAR-T) Immunotherapy was approved by the FDA in October 2017 for adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy. CAR-T immunotherapy uses a patient's own T cells and modifies them in a laboratory to recognize and kill the patient's cancer. Since the CAR-T modified cells multiply and persist in the patient's bloodstream, they have the potential to protect the patient against recurrence.Beginning October 1, 2017, two new, unique ICD-10 procedure codes were assigned to CAR-T immunotherapy (XW033C3 for peripheral venous route and XW043C3 for central venous route), allowing for tracking of the procedure in administrative datasets.
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Tags: 486 Source Type: research

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Chimeric Antigen Receptor T-cell (CAR-T) Immunotherapy was first approved by the FDA in October 2017 for adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy. CAR-T immunotherapy uses a patient's own T cells and modifies them in a laboratory to recognize and kill the patient's cancer.Cytokine release syndrome is a known serious adverse event after CAR-T infusion which results in symptoms including fever, nausea, headache, and hypotension. Tocilizumab is an anti-IL-6 receptor antagonist approved for the treatment of CRS in CAR-T patients.
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Tags: 477 Source Type: research
CONCLUSION Third-party EBV-CTLs of defined HLA restriction provide safe, immediately accessible treatment for EBV-PTLD). Secondary treatment with EBV-CTLs restricted by a different HLA allele (switch therapy) can also induce remissions if initial EBV-CTLs are ineffective. These results suggest a promising potential therapy for patients with rituximab-refractory EBV-associated lymphoma after transplantation.TRIAL REGISTRATION Phase II protocols (NCT01498484 and NCT00002663) were approved by the Institutional Review Board at Memorial Sloan Kettering Cancer Center, the FDA, and the National Marrow Donor Program.FUNDING This w...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
Chimeric antigen receptor (CAR) T cell immunotherapy has been a major advancement in cancer therapeutics. Reprogramming of T cells is achieved by using gammaretroviral or lentiviral vectors, which may interfere with human immunodeficiency virus type 1 (HIV-1) nucleic acid amplification testing (NAAT). Here, we describe three clinical scenarios in which CAR T cell immunotherapy interfered with HIV-1 testing, including (i) routine infectious disease screening prior to stem cell transplantation in a 16-year-old female with B cell acute lymphoblastic leukemia, post CAR T cell treatment; (ii) routine infectious disease screenin...
Source: Journal of Clinical Microbiology - Category: Microbiology Authors: Tags: Virology Source Type: research
ConclusionThis is the first case to our knowledge of rapid and durable response of both cSCC and CTCL to immune checkpoint inhibition after allo-HCT. Although this report highlights the potential for significant response to this class of medication, further studies are required to confirm the efficacy and safety of this approach in patients with CTCL after allo-HCT given the potential concern of GVHD.
Source: Journal for Immunotherapy of Cancer - Category: Cancer & Oncology Source Type: research
Chimeric antigen receptor (CAR)-T cell therapy is a new and powerful class of cancer immunotherapy [1,2]. Clinical trials of CAR-T cell therapy targeting the B cell marker CD19 have shown promising results for the treatment of hematologic malignancies, including acute lymphoblastic leukemia (ALL) [3-7], chronic lymphocytic leukemia [8,9], and non-Hodgkin lymphoma (NHL) [10,11]. CAR-T cell therapy targeting B cell maturation antigen (BCMA) has also been demonstrated to be effective for treating multiple myeloma (MM) [12-15].
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Chimeric antigen receptor (CAR)-T cell therapy is a new and powerful class of cancer immunotherapy [1,2]. Clinical trials of CAR-T cell therapy targeting the B-cell marker CD19 have shown promising results for the treatment of hematologic malignancies, including acute lymphoblastic leukemia (ALL) [3 –7], chronic lymphocytic leukemia (CLL) [8,9], and non-Hodgkin lymphoma (NHL) [10,11]. CAR-T cell therapy targeting B-cell maturation antigen (BCMA) has also been demonstrated to be effective for treating multiple myeloma (MM) [12–15].
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
We describe three clinical scenarios in which CAR T- cell immunotherapy interfered with HIV-1 testing including: (1) routine infectious disease screening prior to stem cell transplantation in a 16-year-old female with B-cell acute lymphoblastic leukemia, status post CAR T- cell treatment (2) routine infectious disease screening prior to 2nd CAR T- cell collection in a 65-year-old male with diffuse large B-cell lymphoma who failed initial CAR T- cell treatment and (3) routine infectious risk assessment following an occupational health exposure from a 58 -year-old male with multiple myeloma, status post CAR T- cell treatment...
Source: Clinical Lymphoma and Myeloma - Category: Cancer & Oncology Authors: Tags: J Clin Microbiol Source Type: research
i H Abstract Cancer immunotherapy with immune checkpoint inhibitors (ICIs) such as programmed death ligand-1 (PD-L1) blockers offers pronounced clinical benefit with durable responses and a manageable safety profile. Patients with a high risk of immune-related adverse events are generally excluded from clinical trials testing ICI therapy. Thus, only a little information on the safety and clinical outcome of patients treated with an ICI after allogeneic haematopoietic cell transplantation (HCT) is currently available. Here, we report the characteristics and outcomes of six patients with, respectively, clear cell re...
Source: Swiss Medical Weekly - Category: General Medicine Authors: Tags: Swiss Med Wkly Source Type: research
Publication date: Available online 18 October 2019Source: Best Practice &Research Clinical HaematologyAuthor(s): Mathew L. Cooper, John F. DiPersioAbstractAt present, the only curative therapy for patients with T-cell malignancies is allogeneic stem cell transplant, which has associated risks and toxicities. Novel agents have been tried in relapsed T-cell acute lymphoblastic leukemia (T-ALL), but only one, with 20%-30% complete remission rates, has been approved by the US Food and Drug Administration. T-ALL is a heterogeneous disease, but it has universal overexpression of CD7 as well as several other T-cell markers, s...
Source: Best Practice and Research Clinical Haematology - Category: Hematology Source Type: research
In some patients with multiple myeloma (MM), the original M protein disappears and one or multiple smaller immunoglobulins, called oligoclonal bands (OCB), emerge following autologous stem cell transplant (ASCT). OCB are associated with improved disease-free survival (DFS) and may be associated with early immune system recovery. Patients in phase I/II clinical trials at the University of Maryland Greenebaum Cancer Center who received anti CD3-CD28 co-stimulated and engineered autologous T cells shortly after ASCT had early, rapid, and robust T cell recovery.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Source Type: research
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