Building a safer and faster CAR: Seatbelts, airbags, and CRISPR Journal Article


Authors: Perales, M. A.; Kebriaei, P.; Kean, L. S.; Sadelain, M.
Article Title: Building a safer and faster CAR: Seatbelts, airbags, and CRISPR
Abstract: Therapeutic T cell engineering has recently garnered widespread interest because of the success of CD19 chimeric antigen receptor (CAR) therapy. CARs are synthetic receptors for antigen that redirect the specificity and reprogram the function of the T cells in which they are genetically introduced. CARs targeting CD19, a cell surface molecule found in most leukemias and lymphomas, have yielded high remission rates in patients with chemorefractory, relapsed disease, including acute lymphoblastic leukemia, chronic lymphocytic leukemia, and non-Hodgkin lymphoma. The toxicities of this treatment include B cell aplasia, cytokine release syndrome (CRS), and neurotoxicity. Although reversible in most instances, these toxicities may require specific medical interventions, including transfer to intensive care to treat severe CRS. Guidelines for managing these toxicities are emerging. The recent report of a nonhuman primate model for CRS is poised to help advance the management of this syndrome. Finally, new engineering modalities, based on the use of targeted nucleases like CRISPR, may further enhance the efficacy and safety of CAR T cells. (C) 2017 American Society for Blood and Marrow Transplantation.
Keywords: gene; transplantation; immunotherapy; hematologic malignancies; chimeric antigen receptor; hematopoietic stem cell; tumor rejection; therapy; adoptive immunotherapy; b-cell; acute lymphoblastic-leukemia; vector; t-cell therapy; cytokine release syndrome; lentiviral; cart; adoptive t cell; chimeric antigen receptor t cells; neurologic toxicity
Journal Title: Biology of Blood and Marrow Transplantation
Volume: 24
Issue: 1
ISSN: 1083-8791
Publisher: Elsevier Inc.  
Date Published: 2018-01-01
Start Page: 27
End Page: 31
Language: English
ACCESSION: WOS:000419933800006
DOI: 10.1016/j.bbmt.2017.10.017
PROVIDER: wos
PUBMED: 29032264
PMCID: PMC5901894
Notes: Article reprinted in supplemental issue, see DOI: 10.1016/j.bbmt.2017.12.789 -- Review -- Source: Wos
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  1. Miguel-Angel Perales
    919 Perales
  2. Michel W J Sadelain
    583 Sadelain