CD19 CAR T Cells for B Cell Malignancies After Allogeneic Transplant

Inclusion Criteria

• •Patients with CD19+ B cell malignancy who have persistent, relapsed or progressive disease after hematopoietic stem cell transplant from an human leukocyte antigen (HLA)-matched related donor OR patients with CD19+ B cell malignancy who are planned for or have had a hematopoietic stem cell transplant from an HLA-matched related donor and are at risk of relapse after HCT defined by any one of the disease-specific criteria listed below:
• •* Philadelphia chromosome negative acute lymphoblastic leukemia:
• •* Beyond first complete remission (CR) at the time of pre-transplant evaluation
• •* Required \> 1 cycle of induction chemotherapy to achieve CR
• •* First morphologic CR but with evidence of minimal residual disease by flow cytometry, conventional cytogenetics, fluorescence in situ hybridization (FISH) or polymerase chain reaction (PCR)
• •* First CR with poor risk cytogenetics (t(4:11), t(8;14), hypodiploidy, near triploidy or \> 5 cytogenetic abnormalities) at diagnosis
• •* Planned for or have had a reduced intensity conditioned or non-myeloablative transplant
• •* Philadelphia positive acute lymphoblastic leukemia
• •* Not in CR at the time of pre-transplant evaluation
• •* In CR with the following features:
• •* Intolerant or unwilling to use a TKI after HCT
• •* Current or previous detection of cytogenetic abnormalities in addition to t(9;22) by conventional karyotyping, FISH or molecular methods
• •* Chronic lymphocytic leukemia, or low grade B cell lymphomas:
• •* Failed or ineligible for prior immunochemotherapy that included a purine analog and anti-CD20 monoclonal antibody AND a lymph node \>= 5 cm at the time of pre-transplant evaluation
• •* Mantle cell lymphoma:
• •* Failed or ineligible for autologous transplant AND a lymph node \>= 2 cm at the time of pre-transplant evaluation
• •* Diffuse large B cell lymphomas, large B cell transformation of an indolent lymphoma or other aggressive B cell lymphomas
• •* Failed or ineligible for autologous transplant AND not in CR at the time of pre-transplant evaluation
• •Confirmation of tumor diagnosis and expression of CD19 after review by University of Washington Medical Center (UWMC) or Seattle Cancer Care Alliance (SCCA) pathology services
• •The patient has signed the informed consent form for this study
• •DONOR: Genotypic or phenotypic HLA-identical family members
• •DONOR: Express one or more of the following combinations of viral serostatus and HLA allele:
• •* CMV seropositive and HLA-A\*0101 positive
• •* CMV seropositive and HLA-A\*0201 positive
• •* CMV seropositive and HLA-B\*0702 positive
• •* CMV seropositive and HLA-B\*0801 positive
• •* EBV seropositive and HLA-A\*0201 positive
• •* EBV seropositive and HLA-B\*0801 positive
• •DONOR: Hematocrit \>= 35% at enrollment
• •DONOR: Age \>= 18 years
• •DONOR: The donor has signed the informed consent form for the study