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iCASP9-modified T-lymphocytes + rimiducid is an investigational cell and gene therapy combination developed for patients with hematological malignancies undergoing allogeneic hematopoietic stem cell transplantation. The therapy involves donor-derived T-lymphocytes that have been genetically modified to express the inducible human Caspase-9 (iCASP9) suicide gene and a truncated CD19 (ΔCD19) selection marker. This system acts as a safety switch: if the patient develops acute graft-versus-host disease (GvHD), the small molecule dimerizer rimiducid (AP1903) is administered intravenously. Rimiducid binds to the modified Caspase-9, causing it to dimerize and activate, which rapidly induces apoptosis in the modified T-cells. This approach allows for the beneficial effects of T-cell infusion, such as immune reconstitution and graft-versus-leukemia activity, while providing a mechanism to quickly eliminate the cells if they cause severe GvHD.
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