Cancers & treatments·Regimen libraryCurative

Fludarabine + cyclophosphamide lymphodepletion, then CD19 CAR-T

Checked 2026-09-09

Relapsed or refractory large B-cell lymphoma (second line if refractory or relapse within 12 months), B-ALL, follicular and mantle cell lymphoma

One cycle

every 6 days

6-day cycle, single course (days -5 to 0)Intravenous

Components

Drug	Dose	Route	Days	Note
Fludarabine	30 mg/m² per day	IV	D1-3	days -5 to -3
Cyclophosphamide Alkylating agent (oxazaphosphorine prodrug)	500 mg/m² per day	IV	D1-3	days -5 to -3
CAR-T cells (axicabtagene, lisocabtagene, tisagenlecleucel) CAR-T (CD19)	product-specific dose, e.g. 2 × 10⁶ CAR-positive cells/kg	IV	D6	day 0

Cycles

single course (days -5 to 0)

6-day cycle

Emetogenicity

Moderate (30-90%)

G-CSF

Not routine

Notes

Tocilizumab for CRS grade 2 and above; dexamethasone for ICANS. Bridging therapy is often needed during manufacture.

Used in

Diffuse large B-cell lymphoma Acute lymphoblastic leukaemia Follicular lymphoma Mantle cell lymphoma

Trials

ZUMA-7 TRANSFORM ELIANA

Products

Lisocabtagene maraleucelTisagenlecleucelCyclophosphamideAxicabtagene ciloleucel

Source

ZUMA-7, NEJM 2022

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.