OnCo

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
123456Fludarabine: 30 mg/m² per day, IntravenousFludarabineCyclophosphamide: 500 mg/m² per day, IntravenousCyclophosphamideCAR-T cells (axicabtagene, lisocabtagene, tisagenlecleucel): product-specific dose, e.g. 2 × 10⁶ CAR-positive cells/kg, IntravenousCAR-T cells (axicabtage…
6-day cycle, single course (days -5 to 0)Intravenous

Components

DrugDoseRouteDays
Fludarabine
30 mg/m² per dayIVD1-3
Cyclophosphamide
Alkylating agent (oxazaphosphorine prodrug)
500 mg/m² per dayIVD1-3
product-specific dose, e.g. 2 × 10⁶ CAR-positive cells/kgIVD6
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

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.

Other regimens for these cancers