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Current Hematologic Malignancy Reports

, Volume 13, Issue 6, pp 484–493 | Cite as

Hematopoietic Stem Cell Transplantation in the Era of Engineered Cell Therapy

  • Jacob S. Appelbaum
  • Filippo Milano
CART and Immunotherapy (M Ruella, Section Editor)
Part of the following topical collections:
  1. Topical Collection on CART and Immunotherapy

Abstract

Purpose of Review

Cellular therapy using T cells modified to express chimeric antigen receptors (CAR-T cells) has had striking success in patients that have failed previous treatment for CD19+ B cell non-Hodgkin lymphoma (NHL), chronic lymphocytic leukemia (CLL), or acute lymphoblastic leukemia (ALL). Curative therapy for this group of diseases has previously been limited to allogeneic hematopoietic cell transplantation HCT (alloHCT). The recent results of CAR-T cell therapy raise the question of how best to integrate CAR-T cell therapy and alloHCT in the care of these patients.

Recent Findings

Within the past 2 years, results from larger trials and increased follow-up of patients treated with CD19 CAR-T cell therapy suggest that some may achieve durable remission without transplant.

Summary

The balance of efficacy and toxicity for CAR-T cell therapy and alloHCT vary by disease type, disease status at the time of treatment, patient characteristics, and the specific therapy employed. There are early signals that subsequent transplantation of patients who have achieved remission with CAR-T may be a potentially viable (though expensive) strategy.

Keywords

Cord blood Stem cell transplant CAR-T cells CD-19 CD-20 BCMA 

Notes

Funding Information

This work was supported by a T32 institutional training grant from the National Institutes of Health to Jacob Appelbaum (5T32HL007093).

Compliance with Ethical Standards

Conflict of Interest

Jacob S. Appelbaum and Filippo Milano declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of MedicineUniversity of WashingtonSeattleUSA
  2. 2.Fred Hutchinson Cancer Research CenterSeattleUSA

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