Systematic Review of Immunosuppression After Chimeric Antigen Receptor T-Cell Therapy for Posttransplant Lymphoproliferative Disorder

MethodsTo address this gap, we conducted a systematic review of published data pertaining to CAR T and PTLD following solid organ transplantation. ResultsOur findings reveal substantial variability in immunosuppressive management before and after CAR T cell infusion, including the withholding of immunosuppression, or the use of single agent or combinations of corticosteroids, calcineurin inhibitors, antimetabolites, or mTOR inhibitors.Given the limited data to date, balancing these competing risks is challenging, and no single immunosuppression regimen has emerged as clearly superior. ConclusionsOur review underscores the necessity of an individualised approach to these patients that accounts for factors such as CAR T cell persistence and prolonged B-cell depletion and highlights the need for further research on this clinical scenario.