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

Yongxian Hu; Elaine Tan Su Yin; Yingying Yang; Hengwei Wu; Guoqing Wei; Junwei Su; Qu Cui; Aiyun Jin; Li Yang; Shan Fu; Jianfeng Zhou; Lugui Qiu; Xi Zhang; Aibin Liang; Hongmei Jing; Yuhua Li; Didier Blaise; Mohamad Mohty; Arnon Nagler; He Huang

doi:10.1016/j.retram.2020.06.003

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

Curr Res Transl Med. 2020 Aug;68(3):111-118. doi: 10.1016/j.retram.2020.06.003. Epub 2020 Jun 28.

Authors

Yongxian Hu¹, Elaine Tan Su Yin², Yingying Yang³, Hengwei Wu⁴, Guoqing Wei⁵, Junwei Su⁶, Qu Cui⁷, Aiyun Jin⁸, Li Yang⁹, Shan Fu¹⁰, Jianfeng Zhou¹¹, Lugui Qiu¹², Xi Zhang¹³, Aibin Liang¹⁴, Hongmei Jing¹⁵, Yuhua Li¹⁶, Didier Blaise¹⁷, Mohamad Mohty¹⁸, Arnon Nagler¹⁹, He Huang²⁰

Affiliations

¹ Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China; Institute of Hematology, Zhejiang University, Hangzhou, China. Electronic address: huyongxian2000@aliyun.com.
² Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China; Institute of Hematology, Zhejiang University, Hangzhou, China. Electronic address: elainetansuyin@outlook.com.
³ Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China; Institute of Hematology, Zhejiang University, Hangzhou, China. Electronic address: yangyingying15@zju.edu.cn.
⁴ Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China; Institute of Hematology, Zhejiang University, Hangzhou, China. Electronic address: 457166156@qq.com.
⁵ Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China; Institute of Hematology, Zhejiang University, Hangzhou, China. Electronic address: weiguoqing2000@sina.com.
⁶ 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. Electronic address: zjusujunwei@zju.edu.cn.
⁷ Department of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: cncuiqu@hotmail.com.
⁸ Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China; Institute of Hematology, Zhejiang University, Hangzhou, China. Electronic address: ayjin2007@aliyun.com.
⁹ Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China; Institute of Hematology, Zhejiang University, Hangzhou, China. Electronic address: yanglizju@163.com.
¹⁰ Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China; Institute of Hematology, Zhejiang University, Hangzhou, China. Electronic address: fushan0817@163.com.
¹¹ Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: jfzhou@tjh.tjmu.edu.cn.
¹² State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin, China. Electronic address: qiulg@ihcams.ac.cn.
¹³ Medical Center of Hematology, Xinqiao Hospital, Army Medical University, Chongqing, China. Electronic address: zhangxxi@sina.com.
¹⁴ Department of Hematology, Shanghai Tongji Hospital, Shanghai, China. Electronic address: lab7182@tongji.edu.cn.
¹⁵ Department of Hematology, Peking University Third Hospital, Beijing, China. Electronic address: drjinghm@163.com.
¹⁶ Department of Hematology, Zhujiang Hospital of Southern Medical University, Guangzhou, China. Electronic address: liyuhua2011gz@163.com.
¹⁷ Transplant and Cellular Immunotherapy Programs, Department of Hematology, Institut Paoli-Calmettes, Aix Marseille Univ, CNRS, INSERM, CRCM, Marseille, France. Electronic address: BLAISED@ipc.unicancer.fr.
¹⁸ Sorbonne University, Department of Hematology, Hôpital Saint Antoine, Paris, France; INSERM UMRs 938, EBMT Paris Study Office/CEREST-TC, Paris, France. Electronic address: mohamad.mohty@inserm.fr.
¹⁹ Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel. Electronic address: Arnon.Nagler@sheba.health.gov.il.
²⁰ Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China; Institute of Hematology, Zhejiang University, Hangzhou, China. Electronic address: huanghe@zju.edu.cn.

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.

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

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Betacoronavirus / physiology
COVID-19
Coronavirus Infections / epidemiology
Coronavirus Infections / prevention & control*
Delivery of Health Care / methods
Delivery of Health Care / organization & administration*
Delivery of Health Care / standards
Delivery of Health Care / trends
Hematologic Neoplasms / epidemiology
Hematologic Neoplasms / therapy*
Humans
Immunotherapy, Adoptive* / methods
Immunotherapy, Adoptive* / trends
Infection Control / methods
Infection Control / organization & administration*
Infection Control / standards
Infection Control / trends
Pandemics / prevention & control*
Pneumonia, Viral / epidemiology
Pneumonia, Viral / prevention & control*
Preventive Health Services / methods
Preventive Health Services / organization & administration
Preventive Health Services / standards
Preventive Health Services / trends
Receptors, Antigen, T-Cell / immunology*
SARS-CoV-2

Substances

Receptors, Antigen, T-Cell