The 2022 Tandem Meetings | Optimal lymphodepletion in CAR-T therapy recipients
Nirav Shah, MD, Medical College of Wisconsin, Milwaukee, WI, comments on the results of a study investigating the best lymphodepletion strategy in patients treated with CAR-T therapy. It was found that lower intensity lymphodepletion leads to a lower incidence of neutropenia, lymphopenia, and infectious complications. In the future, it is important to optimize lymphodepletion for each CAR-T product. This interview took place at the Transplantation & Cellular Therapy (TCT) Meetings of ASTCT™ and CIBMTR® 2022 in Salt Lake City, Utah.
Transcript (edited for clarity)
A big question in the CAR-T field is what is the optimal lymphodepletion? We all know that you need some lymphodepletion for the CAR-Ts to be able to proliferate and engraft and be able to exert their cytotoxic effect. But the optimal lymphodepletion has never really been studied. In this abstract, we evaluated patients from our own center that got two different intensities of lymphodepletion. Now, the one challenge of this study is that there were different CAR products, but when strictly looking at some of the outcomes that are related to lymphodepletion, by giving a lower intensity lymphodepletion, we were able to minimize neutropenia, lymphopenia, and therefore, minimizing infectious complications...
A big question in the CAR-T field is what is the optimal lymphodepletion? We all know that you need some lymphodepletion for the CAR-Ts to be able to proliferate and engraft and be able to exert their cytotoxic effect. But the optimal lymphodepletion has never really been studied. In this abstract, we evaluated patients from our own center that got two different intensities of lymphodepletion. Now, the one challenge of this study is that there were different CAR products, but when strictly looking at some of the outcomes that are related to lymphodepletion, by giving a lower intensity lymphodepletion, we were able to minimize neutropenia, lymphopenia, and therefore, minimizing infectious complications. So, I think it’s something that we really need to think about moving forward, rather than just using a one size fits all lymphodepletion, is trying to figure out what is the optimal lymphodepletion for the product that we’re administering because there’s no doubt that lymphodepletion does have side effects as well.
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