Léčba lymfomů CAR-T lymfocyty

Abstract

CAR-T lymphocytes have become an integral part of the treatment arsenal for hematological malignancies, including B-non-Hodgkin's lymphomas (B-NHL). Currently, we have four registered anti-CD19 products available for the treatment of B-NHL. For the treatment of large B-cell lymphomas (LBCL) and follicular lymphoma (FL), axi-cel, liso-cel, and tisa-cel are available, while brexu-cel is registered for the treatment of mantle cell lymphoma (MCL). Registered indications are mostly for the treatment of 3rd and subsequent lines, but for LBCL we can use axi-cel and liso-cel already in the second line. The presented work addresses: 1. general selection of suitable patients in terms of age and comorbidities, 2. pre-treatment examinations, 3. estimating the risks of adverse effects, 4. the adverse effects, 5. expected outcomes, 6. decision-making algorithms or elements of decision-making algorithms for each malignancy. In the  chapter about LBCL, case report is included. The main aim of the work is to assist clinicians who first diagnose relapsed patients and decide on their referral to specialized centers.