Table 1 The influence of different CAR-T targets on the immune system
Antigen | Expressed on which cells | Effect on the immune system | Tumor Target | The issue of COVID-19 |
|---|---|---|---|---|
B-cell leukemia/lymphoma | ||||
CD19* | Most B-cell malignancies and most normal B-cell lineages | • B-cell aplasia contributes to hypogammaglobulinemia and impaired humoral immunity • Neutropenia | B-ALL, DLBCL, FL, MCL | • High risk of severe/critical • Longer hospitalization [6, 29] • High mortality rate [6, 29] • Low serological response rate after vaccination (57%) [37]; may have lower serological response rate compared with BCMA-based CAR-T (76.4%) [38] • Low rates of seroconversion and prolonged viral shedding [39, 40] • Longer duration of COVID-19 symptoms [29] • Prone to reinfection and rebound positivity • May be more likely to give rise to multimutational SARS-CoV-2 variants [41] |
CD22 | Most B-cell malignancies and most normal B-cell lineages | B-NHL | ||
CD20 | Most B-cell malignancies and most normal B-cell lineages | B-ALL | ||
Multiple myeloma | ||||
BCMA* | Mainly in plasma blast cells and terminally differentiated plasma cells | • B-cell aplasia contributes to hypogammaglobulinemia and impaired humoral immunity • Neutropenia | MM, PPCL, POEMS, AL | • As described above, the concern is that there may be a higher mortality rate (41%) [42] than with CD19 CAR-T (20%) [43] |
GRPC5D | Highly expressed on normal and malignant plasma cells | MM | ||
T-cell leukemia/lymphoma | ||||
CD7 | T cells and natural killer cells and their precursors | • T-cell aplasia contributes to impaired cellular immunity • Neutropenia | T-ALL, T-LBL | • Healthy donor T cells may increase the risk of GVHD after COVID-19 • Delayed viral clearance |
CD5 | All T cells and B1 cell subset | T-ALL | ||
Acute myelogenous leukemia | ||||
CD123 | AML cells; B-ALL cells; HD; hematopoietic stem cells; dendritic cells | • Effect on hematopoiesis • Damage to hematopoietic stem cells | AML | • Delayed recovery of hematopoietic function |
Hodgkin lymphoma | ||||
CD30 | Highly expressed on HD and anaplastic large-cell lymphoma; activated T cells, B cells and NK cells | • Affect the balance of the T-cell subsets • Transient neutropenia | HD | • Delayed viral clearance |