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For Phase 1: Patient must have relapsed or refractory B-cell NHL (with the exception of Burkitt lymphoma and lymphoblastic lymphoma) or CLL that has progressed after standard therapies, including chemotherapy and anti-CD20 antibody combinations and molecularly targeted therapies. Patients may also have undergone prior stem cell transplant and/or prior CD19-directed CAR-T cell therapy |
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For Phase 2: Patient must have the following |
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Arm 1E: Relapsed or refractory DLBCL, including high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements, primary mediastinal large B-cell lymphoma and transformed FL. All patients must have progressed after at least 2 lines of therapy, including induction therapy with an anthracycline-based regimen with anti-CD20 antibody, as well as a second systemic therapy. Patients may have also received prior stem cell transplant or CD19-directed CAR-T therapy |
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Arm 2E: Relapsed or refractory FL. All patients must have progressed after at least 2 lines of therapy. Patients may have also received prior stem cell transplant or CD19-directed CAR-T therapy |
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Arm 2E-Basket: Relapsed or refractory B-cell NHL subtypes that have progressed after available therapies. This "basket" arm will include but is not limited to MCL, MZL, WMG, Burkitt and Burkitt-like lymphoma, and HCL. Patients may have also received prior stem cell transplant or CD19-directed CAR-T therapy |
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Arm 3E: Relapsed or refractory CLL/SLL All patients must have progressed after prior Bruton's tyrosine kinase (BTK) and/or BCL-2 directed therapy. Patients may have also progressed or have been intolerant to prior BTK and anti-CD20 antibody therapy. Patients may have also received prior stem cell transplant or CD19 CAR-T therapy |
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For patients treated with prior CD19-directed CAR-T therapy (all arms): relapsed from |
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PR or CR of ≥ 3 months' duration with CD19-positive or -negative disease, or |
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relapsed from PR or CR at any time with CD19-negative disease |
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For patients treated with prior CD19-directed CAR-T therapy, the peripheral blood absolute CD19+ B-cell count, as measured by flow cytometry, has recovered to at least 20 cells/μl |
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For patients with NHL, at least 1 measurable lesion according to the revised International Working Group (IWG) Response Criteria for Malignant Lymphoma |
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For patients with CLL, diagnosis of CLL that meets published diagnostic criteria. Measurable disease is not required |
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Evidence of CD20 expression on the tumor specimen obtained from the original diagnostic biopsy or another tissue biopsy performed prior to enrollment into this study |
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At least 2 weeks or 5 half-lives, whichever is shorter, have elapsed since any prior systemic therapy before the subject's planned leukapheresis, with the exception of prior BTK inhibitor therapy, which can continue until day -6 (1 day prior to lymphodepletion) |
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Males and females ≥18 years of age at the time of consent |
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Capable of understanding, willing to comply with, and voluntarily sign and date an informed consent form prior to the conduct of any study related assessments/procedures |
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Able to adhere to the study visit schedule and other protocol requirements |
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Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 |
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Life expectancy of ≥ 16 weeks, as assessed by the Principal Investigator |
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All patients must meet all of the following laboratory criteria unless, in the opinion of the Investigator, the cytopenias are considered to be the result of marrow infiltration by lymphoma/CLL |
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Absolute neutrophil count (ANC) ≥ 0.75×10e9/L |
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Platelet count ≥ 75×10e9/L |
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Hemoglobin ≥ 8.5 g/dL |
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Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) < 2.5× the upper limit of normal (ULN) |
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Calculated creatinine clearance ≥ 45.0 mL/minute as estimated by Cockcroft-Gault formula |
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Total bilirubin ≤ 1.5×ULN, unless due to suspected Gilbert's syndrome |
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Adequate pulmonary function, defined as ≤ Grade 1 dyspnea and oxygen saturation (SaO2) |
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≥ 92% on room air. If pulmonary function tests (PFTs) are performed based on |
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the clinical judgment of the treating physician, patients with forced |
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expiratory volume in 1 second (FEV1) ≥ 50% of predicted and diffusing capacity |
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for carbon monoxide (DLCO) (corrected) of ≥ 40% of predicted will be eligible |
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Left ventricular ejection fraction ≥ 50%, as determined by echocardiography (ECHO) or multi-gated acquisition scan (MUGA) |
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Females of childbearing potential must have a negative serum or urine pregnancy test at screening and negative serum or urine pregnancy test prior to initiation of the lymphodepletion regimen |
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If procreative potential exists, patient must agree to use a highly effective method of contraception from the start of the study until 1 year after the completion of lymphodepletion for females and 4 months after completion of lymphodepletion for males |
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Patients who meet ANY of the following criteria will be excluded from the study
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Previous treatment with anti-CD20 or anti-CD19 therapy (including antibodies, antibody-drug conjugates [ADCs], bispecific antibodies, etc.) within 4 weeks before leukapheresis
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Concurrent known additional malignancy that is progressing and/or requires active treatment. Exceptions include squamous or basal cell carcinoma of the skin, superficial bladder cancer, and prostate cancer not requiring treatment
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Presence of active acute or chronic Graft versus Host Disease (GVHD)
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Active central nervous system (CNS) lymphoma, including primary CNS lymphoma
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Corticosteroid dependence on doses greater than physiological replacement, i.e., requirement for prednisone > 7.5 mg/day or hydrocortisone ≥ 12 mg/m2/day
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Ongoing prior therapy-related toxicities ≥ Grade 2, according to the Common Toxicity Criteria for Adverse Events (CTCAE), version 5.0, with the exception of alopecia or vitiligo or Grade 2 peripheral neuropathy
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Active systemic infections, active, uncontrolled coagulation or bleeding disorders, or other active, uncontrolled major medical illnesses of the respiratory or immune system
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Simple upper respiratory tract infection, uncomplicated bacterial pharyngitis and/or urinary tract infection are permitted if responding to active treatment and after consultation with the study Medical Monitor
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Cardiac involvement with lymphoma, including pericardial involvement and
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malignant pericardial effusion
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Significant cardiovascular diseases within the past 6 months including uncontrolled congestive heart failure (>New York Heart Association class II), myocardial infarction, unstable angina, or uncontrolled arrhythmia. However, patients with ischemic heart disease who have had acute coronary syndrome, myocardial infarction and/or revascularization > 6 months before Screening, who are without cardiac symptoms, may enroll
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Requirement for urgent therapy due to tumor mass effects such as bowel obstruction or blood vessel compression
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Documented human immunodeficiency virus (HIV) infection or any form of primary immunodeficiency, such as severe combined immunodeficiency disease
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Known active infection with hepatitis B, hepatitis C, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or other viral infections requiring systemic therapy
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History of autoimmune disease (e.g., Crohn's disease, rheumatoid arthritis, systemic lupus) resulting in end organ injury or requiring systemic immunosuppression/systemic disease modifying agents within the previous 2 years
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If female, pregnant, planning to become pregnant, or breastfeeding
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Any other clinically significant medical disease or condition that, in the Principal Investigator's opinion, may interfere with protocol adherence or the patient's ability to provide informed consent
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