Chimeric antigen receptor (CAR) T cells have emerged as a potent therapeutic approach for patients with certain haematological cancers, with multiple CAR T cell products currently approved by the FDA for those with relapsed and/or refractory B cell malignancies. However, in order to derive the desired level of effectiveness, patients need to successfully receive the CAR T cell infusion in a timely fashion. This process entails apheresis of the patient’s T cells, followed by CAR T cell manufacture. While awaiting infusion at an authorized treatment centre, patients may receive interim disease-directed therapy. Most patients will also receive a course of pre-CAR T cell lymphodepletion, which has emerged as an important factor in enabling durable responses. The time between apheresis and CAR T cell infusion is often not a simple journey, with each milestone being a critical step that can have important downstream consequences for the ability to receive the infusion and the strength of clinical responses. In this Review, we provide a summary of the many considerations for preparing patients with B cell non-Hodgkin lymphoma or acute lymphoblastic leukaemia for CAR T cell therapy, and outline current limitations and areas for future research.

嵌合抗原受体 (CAR) T 细胞已成为某些血液癌症患者的有效治疗方法，目前 FDA 批准了多种 CAR T 细胞产品用于复发和/或难治性 B 细胞恶性肿瘤患者。然而，为了获得所需的有效性水平，患者需要及时成功地接受 CAR T 细胞输注。这个过程需要对患者的 T 细胞进行单采分离，然后进行 CAR T 细胞的制造。在授权的治疗中心等待输注时，患者可能会接受临时的疾病导向治疗。大多数患者还将接受 CAR T 细胞前淋巴细胞清除疗程，这已成为实现持久反应的重要因素。单采和 CAR T 细胞输注之间的时间往往不是一个简单的旅程，每个里程碑都是关键步骤，可能对接受输液的能力和临床反应的强度产生重要的下游影响。在这篇综述中，我们总结了为 B 细胞非霍奇金淋巴瘤或急性淋巴细胞白血病患者准备 CAR T 细胞治疗的许多注意事项，并概述了当前的局限性和未来研究的领域。