CD19 is a protein found on the surface of B cells, both normal and cancerous. Many B-cell malignancies express CD19, making it a critical target for immunotherapies like CAR-T therapy. CD19 CAR-T cell therapy is a breakthrough treatment that modifies a patient’s own T cells to recognize and attack CD19-positive cancer cells.
This therapy has revolutionized treatment for patients with relapsed or refractory B-cell cancers, offering long-term remission when other treatments have failed.
Key Diseases That Express CD19 and Are Treated with CAR-T Therapy
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Large B-Cell Lymphoma (LBCL)
This broad category includes several aggressive lymphomas, such as:
- Diffuse Large B-Cell Lymphoma (DLBCL): The most common and aggressive type.
- Primary Mediastinal B-Cell Lymphoma (PMBCL): Primarily affects the chest area.
- High-Grade B-Cell Lymphoma (HGBCL): A particularly aggressive form with genetic mutations.
- Follicular Lymphoma (FL) (Grade 3B): A high-grade version of follicular lymphoma.
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Acute Lymphoblastic Leukemia (ALL)
- B-Cell Acute Lymphoblastic Leukemia (B-ALL): A fast-growing leukemia that occurs in both children and adults.
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Chronic Lymphocytic Leukemia (CLL) / Small Lymphocytic Lymphoma (SLL)
- Slow-growing B-cell malignancies that can become resistant to conventional therapies.
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Mantle Cell Lymphoma (MCL)
- A rare but aggressive lymphoma that has responded well to CD19-targeted CAR-T therapies.
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Follicular Lymphoma (FL)
- In certain cases, relapsed or refractory follicular lymphoma can be successfully treated with CD19 CAR-T therapy.
How CD19 CAR-T Therapy Works
CD19 CAR-T therapy is a form of personalized immunotherapy designed to target B-cell cancers by using the patient’s own immune system. The treatment follows these key steps:
- T Cell Collection: A sample of T cells is extracted from the patient’s blood.
- Genetic Modification: The T cells are engineered in a laboratory to express a Chimeric Antigen Receptor (CAR) that specifically recognizes CD19 on cancerous B cells.
- Cell Expansion: The modified T cells are multiplied in large numbers.
- Infusion into the Patient: The CAR-T cells are reinfused into the patient, where they seek out and destroy CD19-positive cancer cells.
Approved CD19 CAR-T Therapies
Several FDA-approved CD19-targeted CAR-T therapies are currently available for B-cell cancers:
- Axicabtagene ciloleucel (Yescarta)
- Tisagenlecleucel (Kymriah)
- Lisocabtagene maraleucel (Breyanzi)
- Brexucabtagene autoleucel (Tecartus) (approved for Mantle Cell Lymphoma)
Impact of CD19 CAR-T Therapy
CD19 CAR-T therapy has transformed the treatment landscape for B-cell malignancies. It provides a high response rate and potential long-term remission for patients who have exhausted other treatment options. While it is not suitable for all cases, CAR-T therapy continues to evolve, offering new hope to patients battling aggressive B-cell cancers.
Publication date: March 2025