TY - CHAP M1 - Book, Section TI - Immune Cell Therapy: Genetically Engineered T Cells A1 - Lichtman, Marshall A. A1 - Kaushansky, Kenneth A1 - Prchal, Josef T. A1 - Levi, Marcel M. A1 - Burns, Linda J. A1 - Linch, David C. PY - 2022 T2 - Williams Manual of Hematology, 10e AB - The potent antitumor activity of T cells against many hematologic malignancies is illustrated by the graft-versus-leukemia effect of both allogeneic hematopoietic stem cell transplantation and donor lymphocyte infusion (see Chap. 39).Autologous T cells recognizing tumor neoantigens are found in the microenvironment of many cancers.These tumor-specific T cells are often downregulated by the expression of the tumor cells of a range of immune checkpoint molecules.Attempts to expand tumor-reactive T cells in vivo using interleukin (IL)-2 infusions have met with some success in selected solid cancers such as melanoma but have not been very successful in the hematologic malignancies.Attempts to expand in vitro and subsequently reinfuse tumor-infiltrating T cells (TILs) has had considerable success in melanoma and some other solid tumors but is logistically highly demanding. Continued trials are in progress.The use of ex vivo expanded Epstein-Barr virus (EBV)-specific T cells has proven efficacious in EBV-driven lymphoproliferative disorders.Infusion of bispecific T-cell engagers (BiTEs) and trispecific T-cell engagers (TriTEs) enables a wide range of previously nonspecific T cells to be recruited to tumor cells, leading to tumor cell death. They are effective in a number of hematologic malignancies.An alternative strategy to recruit a wider pool of autologous T cells to tumor cell killing is to genetically engineer T cells, harvested by leukapheresis, so that they recognize a tumor-selective antigen. This can be done by transfecting these cells either with a specific T-cell receptor (TCR) or with a chimeric antigen receptor (CAR). SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/06 UR - hemonc.mhmedical.com/content.aspx?aid=1189334335 ER -