Publications by authors named "Juan L Reguera-Ortega"

Multiple myeloma (MM) remains incurable, with poor outcomes in heavily pre-treated patients with plasmacytomas. Chimeric antigen receptor (CAR) T-cell therapy has emerged as a promising treatment option; however, outcomes after such therapy in patients with soft-tissue plasmacytomas and other bone lesions remain poorly understood. Data regarding these parameters is scarce within the specific context of CAR T-cell treatment.

View Article and Find Full Text PDF
Article Synopsis
  • Immune effector cell-associated hematotoxicity (ICAHT) is a common complication in CAR-T cell therapy, leading to significant thrombocytopenia in about one-third of patients, often necessitating platelet transfusions.
  • Eltrombopag, a thrombopoietin receptor agonist, was evaluated in a study involving 38 patients from 10 hospitals in Spain who developed platelet transfusion dependence after CAR-T treatment.
  • The results showed that 76.3% of patients achieved platelet transfusion independence after using eltrombopag, with additional improvements noted in neutrophil and red blood cell counts, and no serious side effects reported.
View Article and Find Full Text PDF
Article Synopsis
  • CAR therapy targeting BCMA is being improved with the new anti-BCMA CAR called CARTemis-1, which aims to be more effective against multiple myeloma, addressing the challenges of current treatments that lack sustained effectiveness.
  • The study demonstrated that the longer version of CARTemis-1 showed better cancer-killing ability and confirmed that certain manufacturing conditions, like specific cytokines, enhance CAR-T cell quality and effectiveness.
  • CARTemis-1 was found to be effective without being inhibited by soluble BCMA, and it successfully met regulatory standards for production while exhibiting strong antitumor effects in both lab and live models.
View Article and Find Full Text PDF

Chimeric antigen receptor (CAR)-T cell therapy is approved for the treatment of relapsed/refractory (R/R) large B cell lymphoma (LBCL). However, elderly patients might not be candidates for this therapy due to its toxicity, and criteria for candidate selection are lacking. Our aim was to analyze efficacy and toxicity results of CAR-T cell therapy in the population of patients 70 years and older as compared to those obtained in younger patients in the real-world setting.

View Article and Find Full Text PDF

Bridging therapy (BT) after leukapheresis is required in most relapsed/refractory (R/R) large B-cell lymphoma (LBCL) patients receiving chimeric antigen receptor (CAR) T cells. Bendamustine-containing regimens are a potential BT option. We aimed to assess if this agent had a negative impact on CAR-T outcomes when it was administered as BT.

View Article and Find Full Text PDF

An unmet need exists for patients with relapsed/refractory (R/R) follicular lymphoma (FL) and high-risk disease features, such as progression of disease within 24 months (POD24) from first-line immunochemotherapy or disease refractory to both CD20-targeting agent and alkylator (double refractory), due to no established standard of care and poor outcomes. Chimeric antigen receptor (CAR) T cell therapy is an option in R/R FL after two or more lines of prior systemic therapy, but there is no consensus on its optimal timing in the disease course of FL, and there are no data in second-line (2L) treatment of patients with high-risk features. Lisocabtagene maraleucel (liso-cel) is an autologous, CD19-directed, 4-1BB CAR T cell product.

View Article and Find Full Text PDF
Article Synopsis
  • * Out of 439 patients analyzed, those who had received bendamustine prior to apheresis showed significantly lower overall response rates, progression-free survival, and overall survival compared to those who had not received the drug.
  • * The results indicate that recent bendamustine exposure particularly worsens outcomes, highlighting the importance of treatment history in managing patients eligible for CAR T-cell therapy.
View Article and Find Full Text PDF

The aim of this paper was to review the available evidence on the efficacy and safety of combined or sequential use of PD-1/PD-L1 immune checkpoint inhibitors (ICI) and CAR-T cell therapies in relapsed/refractory (R/R) haematological malignancies. A systematic literature review was performed until 21 November 2022. Inclusion criteria: cohort studies/clinical trials aimed at evaluating the efficacy and/or safety of the combination of CAR-T cell therapy with PD-1/PD-L1 inhibitors in R/R haematological malignancies, which had reported results.

View Article and Find Full Text PDF

Purpose: CAR-T cell therapy has proven to be a disruptive treatment in the hematology field, however, less than 50% of patients maintain long-term response and early predictors of outcome are still inconsistently defined. Here, we aimed to optimize the detection of CD19 CAR-T cells in blood and to identify phenotypic features as early biomarkers associated with toxicity and outcomes.

Experimental Design: In this study, monitoring by flow cytometry and digital PCR (dPCR), and immunophenotypic characterization of circulating CAR-T cells from 48 patients treated with Tisa-cel or Axi-cel was performed.

View Article and Find Full Text PDF

Donor derived regulatory T lymphocytes and the JAK1/2 kinase inhibitor ruxolitinib are currently being evaluated as therapeutic options in the treatment of chronic graft versus host disease (cGvHD). In this work, we aimed to determine if the combined use of both agents can exert a synergistic effect in the treatment of GvHD. For this purpose, we studied the effect of this combination both in vitro and in a GvHD mouse model.

View Article and Find Full Text PDF

Tisagenlecleucel (tisa-cel) is a second-generation autologous CD19-targeted chimeric antigen receptor (CAR) T-cell therapy approved for relapsed/refractory (R/R) large B-cell lymphoma (LBCL). The approval was based on the results of phase II JULIET trial, with a best overall response rate (ORR) and complete response (CR) rate in infused patients of 52% and 40%, respectively. We report outcomes with tisa-cel in the standard-of-care (SOC) setting for R/R LBCL.

View Article and Find Full Text PDF

Antimicrobial stewardship programs (ASPs) in hematological patients are especially relevant. However, information about ASPs in this population is scarce. For 11 years, we quarterly assessed antimicrobial consumption and incidence and death rates of multidrug-resistant (MDR) bloodstream infections (BSI) in the hematology Department.

View Article and Find Full Text PDF

Chimeric antigen receptor (CAR) T-cell therapy is one of the most promising emerging treatments for B-cell malignancies. Recently, two CAR T-cell products (axicabtagene ciloleucel and tisagenlecleucel) have been approved for patients with aggressive B-cell lymphoma and acute lymphoblastic leukemia; many other CAR-T constructs are in research for both hematological and non-hematological diseases. Most of the patients receiving CAR-T therapy will develop fever at some point after infusion, mainly due to cytokine release syndrome (CRS).

View Article and Find Full Text PDF