axicabtagene ciloleucel at a glance
Medicine class
Autologous CD19-directed CAR T-cell therapy
Main uses
Selected diffuse large B-cell, high-grade B-cell, primary mediastinal large B-cell and follicular lymphomas in adults
Administration
Intravenous infusion in a qualified specialist treatment centre
Personalised product
Manufactured from the individual patient’s collected T cells and intended only for that patient
What is axicabtagene ciloleucel used for?
UK-licensed uses in adults include:
Diffuse large B-cell lymphoma or high-grade B-cell lymphoma that is refractory to first-line chemoimmunotherapy or relapses within 12 months after completing it.
Relapsed or refractory diffuse large B-cell lymphoma or primary mediastinal large B-cell lymphoma after at least two previous lines of systemic therapy.
Relapsed or refractory follicular lymphoma after at least three previous lines of systemic therapy.
How does axicabtagene ciloleucel work?
The patient’s T cells are modified to carry a chimeric antigen receptor that recognises CD19 on malignant and normal B cells. This activates the T cells, causing them to multiply, release immune signals and kill CD19-expressing cells.
How to take axicabtagene ciloleucel
This treatment is not taken at home. The patient’s T cells are collected, modified in a laboratory and returned by intravenous infusion at a qualified treatment centre after preparatory chemotherapy. Identity checks, close monitoring and remaining near the specialist centre afterwards are required.
Carry the supplied patient alert card and show it to healthcare professionals providing care.
Do not drive or operate heavy or dangerous machinery until the required recovery period has passed and neurological effects have resolved.
Do not donate blood, organs, tissues or cells for transplantation after treatment.
axicabtagene ciloleucel side effects
Common or expected effects
- Cytokine release syndrome, often involving fever, chills, low blood pressure, fast heartbeat or low oxygen levels
- Confusion or other brain-function changes, tremor, headache and dizziness
- Bacterial or viral infections
- Reduced white cells, red cells or platelets
- Reduced immunoglobulin levels
- Tiredness, reduced appetite, nausea or diarrhoea
Get urgent medical advice
- High temperature, breathing difficulty, faintness or severe weakness
- New confusion, agitation, speech or writing difficulty, marked drowsiness, seizures or reduced consciousness
- Signs of severe infection
- Unusual bruising or bleeding
- Severe allergic reaction, including swelling, wheezing or collapse
- Reduced urine output or other features of tumour lysis syndrome
axicabtagene ciloleucel in pregnancy
There are no adequate pregnancy data, and fetal harm is possible if modified cells cross the placenta. Treatment is not recommended during pregnancy or without effective contraception; pregnancy status is checked beforehand. Discuss pregnancy during or after treatment promptly with the specialist team.
axicabtagene ciloleucel while breastfeeding
It is unknown whether modified cells pass into human milk, and risk to a breastfed child cannot be excluded. The specialist team must weigh the benefit of breastfeeding against the benefit and timing of treatment.
axicabtagene ciloleucel interactions
Formal interaction studies have not been performed. Tell the specialist team about all medicines and planned vaccinations.
Systemic corticosteroids
Preventive use before infusion may interfere with CAR T-cell activity, although specialists may use corticosteroids to manage treatment toxicity.
Live viral vaccines
Live vaccination is avoided around treatment and until immune recovery because safety has not been established.
Common questions about axicabtagene ciloleucel
Answers are fully visible for fast scanning and source review.
What is axicabtagene ciloleucel made from?
The patient’s own T cells, which are collected and genetically modified to recognise CD19.
Why must it be given at a specialist centre?
It can cause rapidly developing immune and neurological reactions requiring trained staff, close monitoring and immediate access to emergency treatment.
What is cytokine release syndrome?
An inflammatory reaction caused by activated CAR T cells. Features may include fever, low blood pressure, fast heartbeat, chills and breathing difficulty and require prompt assessment.
Does it increase infection risk?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.