Chimeric Antigen Receptor T-Cell Therapy in Autoimmune Disorders: An Expert Panel Opinion From the American Society for Transplantation and Cellular Therapy.

Chimeric antigen receptor (CAR) T-cell therapy is a standard of care in many lymphoid malignancies and has emerged as potentially curative. A unique property of this one-time treatment is profound and long-lasting B cell depletion, hence the quest to explore its impact in the treatment of severe autoimmune disorders. Early trials in select populations have shown preliminary benefit. However, many questions persist as to how best to deploy this potentially highly effective therapy in the treatment of autoimmune disorders. The American Society for Transplantation and Cellular Therapy Committee on Cellular Therapy convened a group of experts in hematology, oncology, and autoimmunity to provide in a question and answer format a review of the existing publications on CAR-T cell therapy in autoimmune disorders including subtypes, discuss types of clinical trials, strategies to optimize patient safety, monitoring and toxicity management, tracking organ dysfunction in different types of autoimmune disorders, and financial considerations with the goal of providing a guide to physicians who want to be involved in CAR-T cell therapy in autoimmune disorders.