Tisagenlecleucel is a CAR T cell therapy for relapsed or refractory large B-cell lymphoma and diffuse large B-cell lymphoma.

Brand Names
Generic Name
DrugBank Accession Number

Tisagenlecleucel is a CD19-directed genetically modified autologous T cell immunotherapy, or a CAR-T cell therapy for B-cell acute lymphoblastic leukemia. It was granted approval by FDA in August 2017 under the market name Kymriah. Tisagenlecleucel is an immunocellular therapy that involves autologous T cells that are collected from each individual patient and genetically engineered to express a specific protein called a chimeric antigen receptor (CAR) that specifically target CD19 antigens. Modified T cells are infused back into the patient's body. These CD19-directed chimeric antigen receptors (CD19 CAR-T cells) direct the T cells to target and kill leukemia cells that express CD19 on the cell surface.

In a multicenter clinical trial involving pediatric and young adult patients with relapsed or refractory B-cell precursor ALL, the overall remission rate within three months of treatment was 83 percent.4

Approved, Investigational
Biologic Classification
Cell transplant therapies
Autologous cell transplant
  • Adoptive immunotherapy agent CTL019
  • CAR.CD19-Redirected T cells
  • Tisagenlecleucel
  • Tisagenlecleucel-T
External IDs
  • CART-19
  • CART19
  • CTL-019
  • CTL019



Tisagenlecleucel is indicated for use in individuals aged 25 years and younger with B-cell precursor acute lymphoblastic leukemia (ALL) that is refractory or in second or later relapse.5

It is also used to treat adult patients with relapsed or refractory (r/r) large B-cell lymphoma after two or more lines of systemic therapy including diffuse large B-cell lymphoma (DLBCL) not otherwise specified, high-grade B-cell lymphoma, and DLBCL arising from follicular lymphoma.5

Tisagenlecleucel is also indicated in adult patients with relapsed or refractory follicular lymphoma after two or more lines of systemic therapy.5

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Associated Conditions
Contraindications & Blackbox Warnings
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Tisagenlecleucel demonstrates efficacy in re-inducing remission in patients with refractory B-cell precursor acute lymphoblastic leukemia. The sole purpose of the therapy is to eliminate CD19-expressing malignant and normal cells with specificity and increased chance of remission.

Mechanism of action

Tisagenlecleucel is a CD19-directed genetically modified autologous T cell immunotherapy that involves genetically modified autologous T cells isolated from each individual patient. The reprogramming of the patient's T cells uses a lentiviral vector to encode an anti-CD19 chimeric antigen receptor (CAR). The CAR is comprised of a murine single-chain antibody fragment (scFv) specific for CD19, followed by a CD8 hinge and transmembrane region that is fused to the intracellular signaling domains from 4-1BB (CD137) and CD3 zeta.5 These intracellular costimulatory signaling domains increase the expansion, longer-term persistence and potency of CAR T cells1,3; the CD3 zeta component is critical for initiating T-cell activation and antitumor activity, while 4-1BB enhances the expansion and persistence of tisagenlecleucel.5,2 Upon binding to CD19-expressing cells, the CAR transmits a signal to promote T-cell expansion, activation, target cell elimination, and persistence of the tisagenlecleucel cells.5

AB-lymphocyte antigen CD19

In pediatric and young adult relapsed/refractory B-cell acute lymphoblastic leukemia (ALL) patients receiving tisagenlecleucel infusion, the mean peak plasma concentration was approximately 34,700 copies/mcg with a median time of 9.91 days to reach this value (Tmax).5

Volume of distribution

The drug is found to be distributed in the blood as well as the bone marrow. Blood to bone marrow partitioning suggested that tisagenlecleucel distribution in bone marrow was 44% of that present in blood at Day 28 while at Months 3 and 6 tisagenlecleucel distributed at 67% and 69%, respectively, indicating high distribution to bone marrow.5

Protein binding

Not Available

Not Available
Route of elimination

Not Available


The mean half life was 16.8 days in pediatric and young adult relapsed/refractory B-cell acute lymphoblastic leukemia (ALL) patients.5


Not Available

Adverse Effects
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Genotoxicity assay, carcinogenicitiy assay, and studies assesssing the effect of drug on fertility have not been conducted for tisagenlecleucel. According to in vitro T cell expansion studies involving transduced T cells from healthy donors and patients, there is no evidence of transformation and immortality.5

Not Available
Pharmacogenomic Effects/ADRs
Not Available


Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Darbepoetin alfaThe risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Tisagenlecleucel.
ErythropoietinThe risk or severity of Thrombosis can be increased when Erythropoietin is combined with Tisagenlecleucel.
Methoxy polyethylene glycol-epoetin betaThe risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Tisagenlecleucel.
PeginesatideThe risk or severity of Thrombosis can be increased when Peginesatide is combined with Tisagenlecleucel.
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Food Interactions
No interactions found.


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Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
KymriahInjection, suspension2000000 1/1IntravenousNovartis Pharmaceuticals Corporation2017-08-30Not applicableUS flag
KymriahSuspension600000000 cellsIntravenousNovartis2019-05-24Not applicableCanada flag
KymriahInjection, suspension60000000 1/1IntravenousNovartis Pharmaceuticals Corporation2018-05-01Not applicableUS flag
Kymriah300600000 cellsIntravenousNovartis Europharm Limited2020-12-16Not applicableEU flag


Drug Categories
Not classified
Affected organisms
Not Available

Chemical Identifiers

CAS number


General References
  1. Tasian SK, Gardner RA: CD19-redirected chimeric antigen receptor-modified T cells: a promising immunotherapy for children and adults with B-cell acute lymphoblastic leukemia (ALL). Ther Adv Hematol. 2015 Oct;6(5):228-41. doi: 10.1177/2040620715588916. [Article]
  2. Wei G, Ding L, Wang J, Hu Y, Huang H: Advances of CD19-directed chimeric antigen receptor-modified T cells in refractory/relapsed acute lymphoblastic leukemia. Exp Hematol Oncol. 2017 Apr 14;6:10. doi: 10.1186/s40164-017-0070-9. eCollection 2017. [Article]
  3. Davila ML, Brentjens RJ: CD19-Targeted CAR T cells as novel cancer immunotherapy for relapsed or refractory B-cell acute lymphoblastic leukemia. Clin Adv Hematol Oncol. 2016 Oct;14(10):802-808. [Article]
  4. FDA Press Announcements: FDA approval brings first gene therapy to the United States [Link]
  5. FDA Approved Drug Products: Kymriah (tisagenlecleucel) suspension for intravenous infusion [Link]
PubChem Substance
FDA label
Download (222 KB)

Clinical Trials

Clinical Trials
3Active Not RecruitingTreatmentNon-Hodgkin's Lymphoma (NHL)1
3CompletedTreatmentAcute Lymphoblastic Leukemia (ALL)1
3RecruitingTreatmentB-cell Acute Lymphoblastic Leukemia / Diffuse Large B-Cell Lymphoma (DLBCL)1
3WithdrawnTreatmentAcute Lymphoblastic Leukemia (ALL)1
2Active Not RecruitingTreatmentB-cell Acute Lymphoblastic Leukemia1
2Active Not RecruitingTreatmentDiffuse Large B-Cell Lymphoma (DLBCL)1
2Active Not RecruitingTreatmentFollicular Lymphoma ( FL)1
2Active Not RecruitingTreatmentInfants With Very High Risk KMT2A B-ALL / Patients With Central Nervous System Relapse Who Did Not Receive Cranial Radiation or Bone Marrow Transplantation / Pediatric and Young Adult Patientswith Hypodiploid or t(17;19) B-ALL1
2Active Not RecruitingTreatmentNon-Hodgkin's Lymphoma (NHL)2
2Active Not RecruitingTreatmentRecurrent Mantle Cell Lymphoma1


Not Available
Not Available
Dosage Forms
Injection, suspensionIntravenous2000000 1/1
Injection, suspensionIntravenous300600.000 cells
Injection, suspensionIntravenous60000000 1/1
SuspensionIntravenous600000000 cells
Not Available
Not Available


Not Available
Experimental Properties
Not Available


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Pharmacological action
General Function
Receptor signaling protein activity
Specific Function
Assembles with the antigen receptor of B-lymphocytes in order to decrease the threshold for antigen receptor-dependent stimulation.
Gene Name
Uniprot ID
Uniprot Name
B-lymphocyte antigen CD19
Molecular Weight
61127.985 Da

Drug created at September 01, 2017 18:43 / Updated at July 02, 2022 14:09