Common brand names

• Kymriah

How it is administered

Tisagenlecleucel is given as a single-dose intravenous (IV) infusion. The medication is made from your own T cells, which are collected from your blood, genetically modified in a laboratory, and then returned to you via infusion. For adults with relapsed or refractory follicular lymphoma, the recommended dose is 0.6 to 6.0 x 10^8 CAR-positive viable T cells, administered as an IV infusion. Before the infusion, you may receive a short course of chemotherapy (called lymphodepleting chemotherapy) to prepare your body for the treatment.

How it works

Tisagenlecleucel is a type of CAR-T cell therapy. It works by using your own immune cells (T cells), which are collected and genetically modified to recognize and attack cancer cells. Specifically, these T cells are engineered to express a chimeric antigen receptor (CAR) that targets CD19, a protein found on the surface of B cells, including those in follicular lymphoma.

Once infused back into your body, these modified T cells seek out and bind to CD19-positive cells, triggering an immune response that destroys both cancerous and normal B cells. This process can lead to a period where you have very few B cells (B-cell aplasia), which is expected and monitored by your healthcare team. The therapy is designed to provide a targeted and powerful attack against blood cancers like follicular lymphoma, especially after other treatments have not worked.

Who should take it

Tisagenlecleucel is indicated for adult patients with relapsed or refractory follicular lymphoma (FL) who have already received two or more lines of systemic therapy. It is also used in adults with relapsed or refractory large B-cell lymphoma after at least two prior treatments, and in children and young adults up to 25 years old with certain types of acute lymphoblastic leukemia (ALL).

If you have follicular lymphoma that has returned or not responded to other treatments, tisagenlecleucel may be considered as a treatment option. Your healthcare team will evaluate your medical history, previous treatments, and current health to determine if tisagenlecleucel is appropriate for you.

Who should not take it

There are no absolute contraindications listed for tisagenlecleucel, but it should not be used in patients with active, uncontrolled infections or unresolved serious side effects from previous treatments. It is also not recommended for women who are pregnant, as the effects on unborn babies are unknown and may be harmful.

Tisagenlecleucel is not indicated for patients with primary central nervous system lymphoma. If you have certain health conditions, such as severe organ dysfunction, or if you are unable to undergo the cell collection and manufacturing process, your doctor may recommend alternative treatments.

Commonly used with

Before tisagenlecleucel infusion, patients typically receive lymphodepleting chemotherapy, which may include fludarabine and cyclophosphamide, or sometimes bendamustine. These medications help prepare your body for the CAR-T cell therapy and improve its effectiveness.

During and after treatment, supportive medications such as acetaminophen and antihistamines are used to reduce infusion-related reactions. Tocilizumab and corticosteroids may be used to manage side effects like cytokine release syndrome.

Commonly tested with

Tisagenlecleucel has been tested in combination with lymphodepleting chemotherapy regimens, such as fludarabine and cyclophosphamide, or bendamustine, as part of the treatment protocol for follicular lymphoma and other blood cancers.

Supportive treatments like tocilizumab (for CRS) and corticosteroids have also been evaluated in clinical studies for managing side effects associated with tisagenlecleucel therapy.