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TREATMENT
DEFINITIONS
repeats): A family of DNA sequences found in the genomes of prokaryotic organisms such as bacteria.
TCR: The T-cell receptor is a molecule found on the surface of
T cells, or T lymphocytes, that is responsible for recognizing fragments of antigen as peptides bound to major histocompatibility complex (MHC) molecules.
A form of cancer immunotherapy. The therapy targets immune checkpoints, key regulators of the immune system
that when stimulated can dampen the immune response to an immunologic stimulus.
A type of treatment in which a patient's T cells
(a type of immune system cell) are changed in the laboratory so they will attack cancer cells. T cells are taken from a patient’s blood. Then the gene for a special receptor that binds to a certain protein on the patient’s cancer cells is added in the laboratory. The special receptor is called a chimeric antigen receptor (CAR). Large numbers of the CAR T cells are grown in the laboratory and given to the patient by infusion. CAR T-cell therapy is being studied in the treatment of some types of cancer. Also called chimeric antigen receptor T-cell therapy.
Also known as an infusion reaction, it is a syndrome that arises as a complication of some diseases or infections, and
is also an adverse effect of some
monoclonal antibody drugs, as well as adoptive T-cell therapies. Severe cases have been called cytokine storms.
ICANS may manifest as delirium, encephalopathy, aphasia, lethargy, tremor, seizures, and, rarely, cerebral edema. In addition, headache is very common and might not represent neurotoxicity per se.
: Allogeneic stem cell transplantation involves transferring the stem cells from a healthy person (the donor) to the patient’s body. Allogeneic, or “off-the-shelf,” treatments can be mass-manufactured from a healthy donor’s cells and used for multiple patients.
CONTRIBUTORS
■ JAMAL MISLEH, MD is a Medical/ Hematologic Oncologist at the Helen F. Graham Cancer Center & Research Institute. He is also a member of the Bone Marrow Transplant & CAR T Cell Program.
■ PETER ABDELMESSIEH, DO is a Hematologic Oncologist at the Helen F. Graham Cancer Center & Research Institute. He is also a member of the Bone Marrow Transplant & CAR T Cell Program.
REFERENCES
1. Park,JH, Riviere I, Gonen, M, et al. Long- Term Follow-Up of CD19 CAR Therapy in Acute Lymphoblastic Leukemia, N Engl J Med 378:449,2018.
2. Neelapu SS. Managing the Toxicities of CAR T-Cell Therapy. Hematol Oncol. Jun; 37 Suppl 1:48-52. doi: 10.1002/ hon.2595,2019.
3. Lin, Q., Zhao, J., Song, Y. et al. Recent Updates on CAR T Clinical Trials for Multiple Myeloma. Mol Cancer 18, 154,https://doi.org/10.1186/s12943- 019-1092-1; 2019.
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Del Med J | May/June 2020 | Vol. 92 | No. 3
