Treating B-cell cancer with T cells expressing anti-CD19 chimeric antigen receptors

Nat Rev Clin Oncol. 2013 May;10(5):267-76. doi: 10.1038/nrclinonc.2013.46. Epub 2013 Apr 2.


Most B-cell malignancies express CD19, and a majority of patients with B-cell malignancies are not cured by current standard therapies. Chimeric antigen receptors (CARs) are fusion proteins consisting of antigen recognition moieties and T-cell activation domains. T cells can be genetically modified to express CARs, and adoptive transfer of anti-CD19 CAR T cells is now being tested in clinical trials. Effective clinical treatment with anti-CD19 CAR T cells was first reported in 2010 after a patient with advanced-stage lymphoma treated at the NCI experienced a partial remission of lymphoma and long-term eradication of normal B cells. Additional patients have subsequently obtained long-term remissions of advanced-stage B-cell malignancies after infusions of anti-CD19 CAR T cells. Long-term eradication of normal CD19(+) B cells from patients receiving infusions of anti-CD19 CAR T cells demonstrates the potent antigen-specific activity of these T cells. Some patients treated with anti-CD19 CAR T cells have experienced acute adverse effects, which were associated with increased levels of serum inflammatory cytokines. Although anti-CD19 CAR T cells are at an early stage of development, the potent antigen-specific activity observed in patients suggests that infusions of anti-CD19 CAR T cells might become a standard therapy for some B-cell malignancies.

Publication types

  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • Animals
  • Antigens, CD19 / immunology*
  • Antineoplastic Agents / therapeutic use
  • Clinical Trials as Topic
  • Combined Modality Therapy
  • Cytokines / blood
  • Cytotoxicity, Immunologic
  • Electroporation
  • Genetic Vectors
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Immunotherapy, Adoptive* / adverse effects
  • Leukemia, B-Cell / immunology
  • Leukemia, B-Cell / therapy*
  • Lymphocyte Activation
  • Lymphocyte Depletion
  • Lymphoma, B-Cell / immunology
  • Lymphoma, B-Cell / therapy*
  • Mice
  • Middle Aged
  • Protein Structure, Tertiary
  • Receptors, Antigen, T-Cell / genetics
  • Receptors, Antigen, T-Cell / immunology*
  • Recombinant Fusion Proteins / immunology
  • Remission Induction
  • T-Lymphocyte Subsets / immunology
  • T-Lymphocyte Subsets / transplantation*
  • T-Lymphocytes, Cytotoxic / immunology
  • T-Lymphocytes, Cytotoxic / transplantation*
  • Xenograft Model Antitumor Assays


  • Antigens, CD19
  • Antineoplastic Agents
  • Cytokines
  • Receptors, Antigen, T-Cell
  • Recombinant Fusion Proteins