CAR T-Cell Therapy for Relapsed/Refractory Aggressive Large B-Cell Lymphoma

Cellular immunotherapy with CD19-directed chimeric antigen receptor (CAR) T-cell therapy has changed the treatment landscape for aggressive B-cell non-Hodgkin lymphoma (B-NHL). Three CAR T-cell therapies are commercially available for the treatment of large B-cell lymphoma. This article reviews a case study to highlight a typical treatment journey for a patient with relapsed large B-cell lymphoma undergoing cellular immunotherapy, including treatment timeline and toxicities, as well as implications for advanced practice providers caring for patients with B-NHL.

At a Glance

• CD19-directed CAR T-cell therapy has shown effectiveness in the treatment of aggressive B-NHL, with some patients achieving durable remissions.
• Cellular immunotherapy can lead to unique toxicities, including cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome.
• Academic and community advanced practice providers manage patients receiving CAR T-cell therapy.