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CAR T-cell treatment during the COVID-19 pandemic: Management strategies and challenges - 19/08/20

Doi : 10.1016/j.retram.2020.06.003 
Yongxian Hu a, b, c, 1 , Elaine Tan Su Yin a, b, c, 1 , Yingying Yang a, b, c , Hengwei Wu a, b, c , Guoqing Wei a, b, c , Junwei Su d , Qu Cui e , Aiyun Jin a, b, c , Li Yang a, b, c , Shan Fu a, b, c , Jianfeng Zhou f , Lugui Qiu g , Xi Zhang h , Aibin Liang i , Hongmei Jing j , Yuhua Li k , Didier Blaise l , Mohamad Mohty m, n , Arnon Nagler o, , He Huang a, b, c,
a Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China 
b Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China 
c Institute of Hematology, Zhejiang University, Hangzhou, China 
d State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China 
e Department of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China 
f Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China 
g State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin, China 
h Medical Center of Hematology, Xinqiao Hospital, Army Medical University, Chongqing, China 
i Department of Hematology, Shanghai Tongji Hospital, Shanghai, China 
j Department of Hematology, Peking University Third Hospital, Beijing, China 
k Department of Hematology, Zhujiang Hospital of Southern Medical University, Guangzhou, China 
l Transplant and Cellular Immunotherapy Programs, Department of Hematology, Institut Paoli-Calmettes, Aix Marseille Univ, CNRS, INSERM, CRCM, Marseille, France 
m Sorbonne University, Department of Hematology, Hôpital Saint Antoine, Paris, France 
n INSERM UMRs 938, EBMT Paris Study Office/CEREST-TC, Paris, France 
o Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel 

Corresponding author at: Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, No.79 Qingchun Road, Hangzhou, China.Bone Marrow Transplantation CenterThe First Affiliated HospitalSchool of MedicineZhejiang UniversityNo.79 Qingchun RoadHangzhouChina⁎⁎Corresponding author.

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Abstract

The pandemic of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading rapidly across the world. Currently, the COVID-19 pandemic is affecting the continuity of essential routine healthcare services and procedures, including chimeric antigen receptor T-cell (CAR-T) therapy, a life-saving option for patients with relapsed/refractory (R/R) hematologic malignancies. Due to the rapid disease progression of hematological malignancies, there is an urgent need to manufacture and utilize CAR T-cells. However, CAR-T treatment has become extraordinarily challenging during this COVID-19 pandemic. Thus, many medical and technical factors must now be taken into consideration before, during, and after CAR-T therapy. The purpose of this review is to provide brief suggestions for rational decision-making strategies in evaluating and selecting CAR T-cell treatment and appropriate CAR T-cell products, and protective strategies for medical staff and patients to prevent infection in the midst of the current COVID-19 pandemic.

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Keywords : Chimeric antigen receptor T-cells, COVID-19, Relapsed/refractory hematological malignancies, Immunocompromised, Cytokine release syndrome


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Vol 68 - N° 3

P. 111-118 - août 2020 Regresar al número
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