Lisocabtagene maraleucel at a glance
Medicine class
CD19-directed autologous CAR T-cell therapy
Main role
Treatment of specified large B-cell, follicular and mantle cell lymphomas in adults
Administration
Intravenous infusion at a qualified specialist treatment centre
Personalised product
Manufactured from the patient’s collected T cells and intended only for that patient
Patient alert card
Carry the supplied CAR T-cell alert card and show it to healthcare professionals
What is Lisocabtagene maraleucel used for?
UK-licensed uses in adults include:
Diffuse large B-cell lymphoma, high-grade B-cell lymphoma, primary mediastinal large B-cell lymphoma or follicular lymphoma grade 3B that is refractory to first-line chemoimmunotherapy or relapses within 12 months of completing it.
Relapsed or refractory diffuse large B-cell lymphoma, primary mediastinal large B-cell lymphoma or follicular lymphoma grade 3B after two or more lines of systemic therapy.
Relapsed or refractory follicular lymphoma after two or more lines of systemic therapy.
Relapsed or refractory mantle cell lymphoma after at least two lines of systemic therapy, including a Bruton's tyrosine kinase inhibitor.
How does Lisocabtagene maraleucel work?
The patient’s T cells are modified to carry a chimeric antigen receptor that binds CD19 on malignant and normal B cells. This activates and expands the T cells, prompting cytokine release and destruction of CD19-bearing cells. Loss of normal B cells can reduce immunoglobulin levels and increase infection risk.
How to take Lisocabtagene maraleucel
Lisocabtagene maraleucel is not taken at home. It is prepared as a patient-specific frozen cell product and infused intravenously by a trained team at a qualified treatment centre.
Identity must be checked carefully against the patient-specific labels before preparation and administration.
The CD8-positive and CD4-positive cell components are kept separate during preparation and administered according to the product-specific release certificate.
The specialist team arranges preparation, premedication and close observation for infusion-related, inflammatory and neurological reactions.
Remain close to the qualified treatment centre and follow its monitoring and emergency-contact instructions.
Do not drive or use potentially dangerous machinery until the treating team says it is safe.
Lisocabtagene maraleucel side effects
Common or expected effects
- Low white cells, red cells or platelets
- Cytokine release syndrome, often involving fever and sometimes low blood pressure or low oxygen
- Fatigue, fever, headache, dizziness or tremor
- Nausea, vomiting, diarrhoea, constipation or abdominal pain
- Cough, rash or swelling
- Infections
Get urgent medical advice
- Fever, chills, breathing difficulty, rapid heartbeat, dizziness or faintness: possible severe cytokine release syndrome or infection
- Confusion, altered alertness, difficulty speaking or writing, tremor, weakness, poor coordination or seizure: possible neurological toxicity
- High temperature with low white-cell counts, or rapidly worsening illness: possible serious infection
- Facial or throat swelling, wheeze, breathing difficulty or collapse: possible anaphylaxis
- Unusual bleeding or bruising: possible severe or prolonged low platelet count
- Reduced urine, marked weakness, muscle cramps or abnormal heartbeat: possible tumour lysis syndrome
Lisocabtagene maraleucel in pregnancy
There are no adequate pregnancy data. Lisocabtagene maraleucel is not recommended during pregnancy because transferred modified cells could potentially harm the fetus, including by reducing fetal B cells. Pregnancy status is checked before treatment; discuss contraception and any pregnancy after treatment with the specialist team, including the implications of preparative chemotherapy.
Lisocabtagene maraleucel while breastfeeding
It is unknown whether the modified cells enter human milk or could be transferred to a breastfed child. Anyone breastfeeding or planning to breastfeed should discuss potential risks and alternatives with the specialist team.
Lisocabtagene maraleucel interactions
Formal human interaction studies have not been performed. Important treatment-related considerations include:
Live viral vaccines
Avoid around treatment and until immune recovery because safety has not been established; agree vaccination plans with the specialist team.
Anti-EGFR monoclonal antibodies
Later use might affect the long-term persistence of the modified T cells, although clinical information is limited.
Systemic corticosteroids
Routine preventive use around infusion is avoided because it may interfere with CAR T-cell activity; corticosteroids may still be required under specialist direction to manage toxicity.
Common questions about Lisocabtagene maraleucel
Answers are fully visible for fast scanning and source review.
What type of treatment is lisocabtagene maraleucel?
It is an autologous CD19-directed CAR T-cell therapy: the patient’s own T cells are collected, genetically modified and returned by intravenous infusion to target B-cell lymphoma cells.
Why must it be given at a specialist centre?
The centre must safely identify, store and administer the personalised cells and promptly recognise and treat serious complications such as cytokine release syndrome and neurological toxicity.
What is cytokine release syndrome?
It is an inflammatory reaction caused by immune activation. Features can include fever, chills, low blood pressure, fast heartbeat and breathing difficulty. Contact the CAR T-cell team immediately.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.