Journal of Blood & Lymph

Non-Hodgkin Lymphoma’s Therapy by CAR-T Cells

Abstract

Micaela Morais, Fernando José Figueiredo Agostinho D’Abreu Mendes and Rui Santos Cruz

Lymphoma is a type of cancer that causes the proliferation of B or T cells in lymph nodes. Lymphomas can be characterized in Hodgkin Lymphoma (HL) and Non-Hodgkin Lymphoma (NHL), which account for about 85% of lymphoma diagnoses. The Immune System (IS) has the innate ability to identify and eliminate cells with tumor potential. Despite this, our body sometimes can’t combat this type of pathologies alone due to the mechanisms of tumor escape. T cells, which are very important cells in antitumor activity, have been studied and some trials show that the use of CAR-T cells may present an added value for the treatment of this type of pathologies. The CAR-T cells are genetically modified T lymphocytes to express the specific antibody binding site, directing autologus polyclonal T cells to bind to a specific Tumor Associated Antigen (TAA). The design and structure of CAR-T are determinant factors in the success of therapy. Four generations of Chimaeric Antigen Receptors (CARs) are known and the difference between they is in their signaling and costimulatory domains, such as CD28 or CD137 (4-1BB). Recent studies show effectiveness in certain cases of patients diagnosed with NHL and it is recognized that the combination of complementary immunotherapy enhances the effect of CAR-T cell therapy. There is still a need to find out which the most appropriate design and which is the ideal dose to maximize efficacy and reduce the toxicity of this therapy.