fludarabine + cyclophosphamide + CAR-NK-CD19 cells

This is a combination therapy consisting of two chemotherapeutic agents, fludarabine and cyclophosphamide, used as lymphodepleting conditioning, followed by infusion of CD19-targeted chimeric antigen receptor-engineered natural killer (CAR-NK) cells. Fludarabine is a nucleoside metabolic inhibitor indicated for B-cell chronic lymphocytic leukemia (CLL), while cyclophosphamide is an alkylating agent commonly used in cancer chemotherapy[6][7]. The addition of CD19-directed CAR-NK cell therapy introduces genetically engineered NK cells that express a chimeric antigen receptor targeting the CD19 antigen on B-cell malignancies. This approach leverages the cytotoxic activity of NK cells against tumor cells expressing CD19 and aims to reduce adverse effects such as graft-versus-host disease and cytokine release syndrome compared to CAR-T therapies[1][3][4]. The primary indication for this combination is relapsed or refractory B-cell malignancies, including CLL and non-Hodgkin lymphoma.