Table 2.
Treatment and effect of CART cell therapy.
| ID | Primary treatment | Conditioning regimen | Lymphodepletion | Infused cells (10^6/kg) | CRS grade | ICANS grade | Neurologic toxicity | ICANS treatment | |
|---|---|---|---|---|---|---|---|---|---|
| CD34+ | CART | ||||||||
| 1 | RCHOP × 3 (PD); isolated CNS relapse; R + HD-MTX + temozolomide + BCL2-inhibitor × 2 (SD) | TEAM | Bendamustine | 5.2 | mCD19 (3.8) | 3 | 3 | Angulus oris convulsion | Mannitol, glucocorticoid, sodium valproate |
| 2 | R-DA-EPOCH × 4 (PR); GVD + PD-1 inhibitor × 2 (PD); isolated CNS relapse; BTKi + HD-MTX + GVD + PD-1 inhibitor × 2 (PD) systemic disease progression and CNS involvement | BEAM | F | 2.23 | mCD19 (1.25) | 1 | 0 | None | Mannitol |
| 3 | R2-CHOPE (PD); spinal cord involvement; R-MT(SD); R-CHOPE + BCL2-inhibitor (PR); HD-MTX + R-CHOPE × 4 (PD); mCD19CART (PR); hCD22CART (PD); systemic disease progression and CNS involvement | BuCy | —— | 2.34 | hCD20 (2.06) | 3 | 0 | None | None |
| 4 | EPOCH × 6 (CR); isolated CNS relapse; HD-MTX + DEX × 2 (PR); isolated CNS relapse. HD-MTX + Idarubicin + DEX (PD); DHAP × 2 (PD); MIDD + BTKi × 6 (PD) | TEAM | Bendamustine | 3.22 | hCD22 (5.9) | 2 | 0 | None | None |
| 5 | RCHOP × 3 (PR); RCHOP × 2 (PD); Isolated CNS relapse; MTX + BTKi + Temozolomide × 4 (CR); isolated CNS relapse (PD) | TEAM | F | 2.37 | hCD19 (3.3) | 3 | 0 | None | Mannitol |
| 6 | R + HD-MTX × 4 (PR); isolated CNS relapse; radiotherapy (PR); systemic disease progression and CNS involvement; ifosfamide + Ara-C × 1 (PD); HD-MTX × 2 (SD); TEDDi-R × 4 (PD); BTKi + BCL2-inhibitor × 4 (SD) | TEAM | FC | 2 | mCD19 (1.93) | 1 | 2 | ICE score 4; awakens to voice | Sodium valproate |
| 7 | RCHOP × 3 (PR); RCHOPE × 4 (CR); ASCT (CR) R × 4 (CR); isolated CNS involvement; R + MTX + temozolomide + BTKi (PD) | TEAM | FC | 2 | mCD19 (2) | 2 | 0 | None | Mannitol |
| 8 | WBRT (CR); systemic disease progression and CNS involvement; HD-MTX + RCHOP × 3 (CR); systemic disease progression and CNS relapse; HD-MTX + RCHOP × 2 (PD) | TEAM | Bendamustine | 3.23 | mCD19 (1.3) | 4 | 4 | Coma, seizures, hallucinations | Mannitol, glucocorticoid, levetiracetam, diazepam |
| 9 | R-CHOPE × 6 (CR); radiation therapy (CR); systemic disease progression. RICE(PD); R2GDP (PD); RDHAP (SD); r-DA-EPOCH(PR); CD19CART (PD); BTKi + radiation (SD); RICE (SD); CD22CART + CD19CART (PR); BCL2-inhibitor + Chidamide (PD) testicular relapse + CNS involvement | —— | —— | —— | hCD20 (1.57) | 1 | 0 | None | None |
| 10 | RCHOP × 6 (CR); intraocular relapse (PD); RCHOP; radiation therapy (PD) RDHAP × 2 (PD); CD19-CART (CR) systemic disease progression and CSF involvement (PD) | —— | F | —— | hCD20 (0.94) | 1 | 0 | None | Mannitol, glucocorticoid |
| 11 | R2 + CHOP × 6 (CR); systemic disease progression; REPOCH × 6 (CR); BEAM + ASCT (CR) systemic disease progression and CNS involvement (PD); HD-MTX + DEX (PD); REPOCH (PD); RGDP (PD); MINE (PD) | —— | FC | —— | hCD19 (1.4) | 1 | 0 | Mannitol, glucocorticoid | |
| 12 | RCHOP(PD); RDHAP (SD); BTKi + CHOP (SD); BTKi + DHAP (SD); BTKi + BCL2-inhibitor (PD) EPOCH (PD); GemOx × 2 (PD) systemic disease progression + CSF involvement | —— | FC | —— | mCD19 (1.485) | 1 | 0 | None | None |
| 13 | EPOCH × 2 (PD); decitabine + EPOCH × 2 (PD) COPADM (PD) systemic disease progression and CSF involvement | —— | —— | —— | mCD19 (0.29) | 3 | 4 | Coma, seizures | Diazepam, mannitol, glucocorticoid, plasmapheresis |
| 14 | RCHOP × 6 (CR); systemic disease progression; R-DICE × 6 (CRu); systemic disease progression; mCD19CART (CR); systemic disease progression and CNS involvement (PD) | —— | FC | —— | hCD19 (0.22) | 0 | 0 | None | None |
| 15 | RB × 6 (CR); systemic disease progression; R-CHOP (PD); REDOCH × 4 (PD); RDHAP + BCL2 inhibitor (PD)CSF involvement + systemic disease progression. | —— | F | —— | mCD19 (1.9) | 2 | 0 | None | Mannitol, glucocorticoid |
| 16 | RCHOP × 4 (PR); RCHOP × 2 (CRu); isolated CNS involvement; RCODOX-M × 2; RCDOP × 4 (CR); BEAM + ASCT (CR); CSF + CNS involvement; radiation (PD); R + MTX(PD)R + MTX + BTKi (PD); MTX + temozolomide + VP-16;CD22CART + CD19CART + BCL2-inhibitor (PD) | —— | —— | —— | hCD20 (1.0) | 3 | 3 | ICE score 2; Awakens only to tactile stimulus; dystaxia | Mannitol, glucocorticoid |
| 17 | RCHOP × 4 (PR); REPOCH (PD); RGDP(PD); RDICE × 2 (PR); RDICE × 2 + BCL2-inhibitor (PD) + BTKi + GemOx(PD); Radiation therapy + Chidamide + lenalidomide (PD); systemic disease progression and CNS involvement (PD) | —— | F | —— | mCD19 (0.26) | 4 | 4 | Coma; seizures | Mannitol, Glucocorticoid, Diazepam, Sodium valproate |
CRS, cytokine-release syndrome; ICANS, immune effector cells associated neurologic toxicity syndrome; CHOP, cyclophosphamide, doxorubicin, vincristine, dexamethasone; HD-MTX, high-dose methotrexate; DA-EPOCH, dose adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin; GVD, gemcitabine, vinorelbine, liposomal adriamycin; CHOPE, cyclophosphamide, doxorubicin, vincristine, dexamethasone, etoposide; DEX, dexamethasone; DHAP, dexamethasone, cytarabine, cisplatin; MIDD, methotrexate, ifosfamide, liposomal Adriamycin, dexamethasone; TEDDi, temozolomide, etoposide, liposomal adriamycin, dexamethasone, intrathecal injection(Ara-C); R2, rituximab, lenalidomide; ASCT, autologous stem cell transplant; WBRT, whole brain irradiation treatment; ICE, ifosfamide, carboplatin, etoposide; DICE, dexamethasone, ifosfamide, carboplatin, etoposide; MINE, mitoxantrone, ifosfamide, etoposide; GDP, gemcitabine, dexamethasone, cisplatin; COPADM, vincristine, high-dose methotrexate, doxorubicin, cyclophosphamide, prednisone; RB, rituximab, bendamustine; GemOx; gemcitabine, oxaliplatin; CODOX-M, cyclophosphamide, vincristine, doxorubicin, methotrexate; TEAM, thiotepa, etoposide, cytarabine, melphalan; BEAM, carmustine, etoposide, cytarabine, melphalan; BuCy, busulfan, cyclophosphamide; F, Fludarabine; FC, Fludarabine, cyclophosphamide; BTKi, Bruton's tyrosine kinase inhibitor; PD-1 inhibitor, programmed death-1 inhibitor; CNS, central nervous system.