Chapter 10 - Relapse Management and Role for Consolidative Hematopoietic Stem Cell Transplantation Following CAR T-Cell Therapy

Abstract

CAR T-cell–therapy represents a promising therapeutic option in patients with relapsed/refractory B-cell malignancies. However, despite encouraging remission induction rates, approximately half of patients are relapsing within a year post-CAR T-cell therapy with either antigen-negative escape or antigen-positive relapse. In this chapter, we will summarize the strategies being used to optimize CAR T-cell response to prevent or treat relapse, including strategies to bolster CAR T persistence and development of multitargeted CAR T-cells to reduce the frequency of antigen-negative relapses. Finally, the data on the role of consolidative hematopoietic stem cell transplantation to prevent relapse following CAR T-cell–induced remission will be reviewed.