title: CAR-modified anti-CD19 T cells for the treatment of B-cell malignancies: rules of the road.
abstract: BACKGROUND
  Malignancies of the B lymphocyte or its precursor include B-cell non-Hodgkin lymphoma as well as chronic and acute lymphoid leukemias. These are among the most common hematologic malignancies and many patients with B-cell malignancies are incurable. Although most patients initially respond to first-line treatment, relapse is frequent and is associated with a poor prognosis. T cells that are genetically engineered to express chimeric antigen receptors (CARs) recognizing the B-cell-associated molecule CD19 have emerged as a potentially potent and exciting therapeutic modality in recent years.
  
  
  METHODS
  This review explores the current peer-reviewed publications in the field and a discussion of expert opinion.
  
  
  CONCLUSIONS
  Genetic engineering of T cells has become clinically feasible and appears to be safe. Here we provide an insight into the process of patient selection, engineered T-cell production, infusion procedure, expected toxicities and efficacy of this exciting approach as it is practiced in the treatment of B-cell malignancies. Anti-CD19-redirected T cells likely represent the vanguard of an exciting new approach to treating cancer.
authors.affiliation: University of Pennsylvania, Abramson Cancer Center, Perelman School of Medicine, Division of Hematology-Oncology, Department of Medicine , Philadelphia, PA 19106 , USA david.porter@uphs.upenn.edu.
authors.forename: Saar
authors.initials: S
authors.lastname: Gill
authors.forename: David L
authors.initials: DL
authors.lastname: Porter
mesh_terms: D000818:Animals; D018941:Antigens, CD19 / Q000378:metabolism*; D015316:Genetic Therapy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D016219:Immunotherapy, Adoptive / Q000009:adverse effects / Q000379:methods*; D016393:Lymphoma, B-Cell / Q000276:immunology / Q000628:therapy*; D018579:Patient Selection; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology / Q000628:therapy*; D011948:Receptors, Antigen, T-Cell / Q000235:genetics / Q000378:metabolism*; D011994:Recombinant Proteins / Q000378:metabolism; D012008:Recurrence; D012307:Risk Factors; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism / Q000637:transplantation*; D016896:Treatment Outcome
chemical_list: D018941:Antigens, CD19; D011948:Receptors, Antigen, T-Cell; D011994:Recombinant Proteins