Calcineurin Inhibitor–Free, mTOR‐Based Immunosuppression in Chimeric Antigen Receptor T‐Cell Therapy for Post‐Transplant Lymphoproliferative Disorder
4 affiliations
- 1Geneva University Hospitals
- 2University of Geneva
- 3Geneva University Hospital
- 4Università Della Svizzera Italiana
Abstract
Introduction
Relapsed/refractory post-transplant lymphoproliferative disorder (PTLD) remains a challenging complication after solid organ transplantation (SOT), requiring complex balancing of immune-suppressive therapy (IST) and lymphoma-directed therapies.Methods
We report the case of a 40-year-old female kidney-pancreas transplant recipient with relapsing monomorphic PTLD treated with CD19-chimeric antigen receptor (CAR) T cells therapy (axicabtagene ciloleucel).Results
Tacrolimus discontinuation and immunosuppression with everolimus and corticosteroids permitted robust CAR T-cell expansion, complete lymphoma remission, and preservation of graft function. In vitro studies showed that tacrolimus inhibited CAR T-cell function, while everolimus preserved it, supporting the use of mTOR-based, calcineurin-inhibitor-free IST during CAR T-cell therapy in SOT recipients.Conclusion
mTOR-based, calcineurin inhibitor-free immunosuppression can preserve CAR T-cell function and enable effective therapy in SOT recipients with PTLD.
Related
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- Calcineurin Inhibitors and Male Fertility in Renal Transplant Recipients: A Comprehensive Review of Molecular Pathomechanisms and Reproductive Toxicity of Cyclosporine A and Tacrolimus.
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BibTeX
@article{mappoura2026calcineurin,
title = {{Calcineurin Inhibitor–Free, mTOR‐Based Immunosuppression in Chimeric Antigen Receptor T‐Cell Therapy for Post‐Transplant Lymphoproliferative Disorder}},
author = {Maria Mappoura and Yara Hajj Younes and Sisi Wang and Kadiatou Baldet and Carmen De Ramon Ortiz and Sarah Morin and Stavroula Marouridi‐Levrat and Amandine Pradier and Astrid Melotti and Pragallabh Purwar and Chiara Bernardi and Liza Ho and Kristof Egervari and Julie Ducreux and Thomas Longval and Francesco Bertoni and Yves Chalandon and Fadi Haidar and Sophie de Seigneux and Jean Villard and Valérie Olivier and Federico Simonetta},
journal = {EJHaem},
year = {2026},
month = oct,
doi = {10.1002/jha2.70437},
url = {https://europepmc.org/article/PMC/PMC13717070},
note = {CC BY},
}
RIS
TY - JOUR
TI - Calcineurin Inhibitor–Free, mTOR‐Based Immunosuppression in Chimeric Antigen Receptor T‐Cell Therapy for Post‐Transplant Lymphoproliferative Disorder
AU - Maria Mappoura
AU - Yara Hajj Younes
AU - Sisi Wang
AU - Kadiatou Baldet
AU - Carmen De Ramon Ortiz
AU - Sarah Morin
AU - Stavroula Marouridi‐Levrat
AU - Amandine Pradier
AU - Astrid Melotti
AU - Pragallabh Purwar
AU - Chiara Bernardi
AU - Liza Ho
AU - Kristof Egervari
AU - Julie Ducreux
AU - Thomas Longval
AU - Francesco Bertoni
AU - Yves Chalandon
AU - Fadi Haidar
AU - Sophie de Seigneux
AU - Jean Villard
AU - Valérie Olivier
AU - Federico Simonetta
PY - 2026
DA - 2026/10/28
JO - EJHaem
DO - 10.1002/jha2.70437
UR - https://europepmc.org/article/PMC/PMC13717070
AB - Introduction Relapsed/refractory post-transplant lymphoproliferative disorder (PTLD) remains a challenging complication after solid organ transplantation (SOT), requiring complex balancing of immune-suppressive therapy (IST) and lymphoma-directed therapies.Methods We report the case of a 40-year-old female kidney-pancreas transplant recipient with relapsing monomorphic PTLD treated with CD19-chimeric antigen receptor (CAR) T cells therapy (axicabtagene ciloleucel).Results Tacrolimus discontinuation and immunosuppression with everolimus and corticosteroids permitted robust CAR T-cell expansion, complete lymphoma remission, and preservation of graft function. In vitro studies showed that tacrolimus inhibited CAR T-cell function, while everolimus preserved it, supporting the use of mTOR-based, calcineurin-inhibitor-free IST during CAR T-cell therapy in SOT recipients.Conclusion mTOR-based, calcineurin inhibitor-free immunosuppression can preserve CAR T-cell function and enable effective therapy in SOT recipients with PTLD.
SN - 2688-6146
ER -