TY - JOUR
T1 - Low toxicity and excellent outcomes in patients with DLBCL without residual lymphoma at the time of CD19 CAR T-cell therapy
AU - Cell Therapy Consortium
AU - Wudhikarn, Kitsada
AU - Tomas, Ana Alarcon
AU - Flynn, Jessica R.
AU - Devlin, Sean M.
AU - Brower, Jamie
AU - Bachanova, Veronika
AU - Nastoupil, Loretta J.
AU - McGuirk, Joseph P.
AU - Maziarz, Richard T.
AU - Oluwole, Olalekan O.
AU - Schuster, Stephen J.
AU - Porter, David L.
AU - Bishop, Michael R.
AU - Riedell, Peter A.
AU - Perales, Miguel Angel
N1 - Publisher Copyright:
© 2023 by The American Society of Hematology.
PY - 2023/7/11
Y1 - 2023/7/11
N2 - CD19 chimeric antigen receptor (CAR) T-cell therapy represents a breakthrough for patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL), inducing sustained remissions in these patients. However, CAR T cells can result in significant toxicities. Preinfusion disease burden is associated with toxicities and outcomes after CAR T-cell therapy. We identified 33 patients with R/R DLBCL treated at 8 academic centers who had no detectable disease at the time of CAR T-cell therapy. The median time from leukapheresis to CAR T-cell infusion was 48 (19-193) days. Nine patients received axicabtagene ciloleucel, and 24 received tisagenlecleucel. There was no severe (grade ≥3) cytokine release syndrome, and only 1 patient developed severe neurotoxicity (grade 4). After a median follow-up of 16 months, 13 patients relapsed (39.4%) and 6 died (18.1%). One-year event-free survival and overall survival were 59.6% and 81.3%, respectively. Our findings suggest that, in patients with R/R DLBCL who have an indication for CAR T-cell therapy, treating patients in complete remission at the time of infusion is feasible, safe, and associated with favorable disease control. Further exploration in a larger clinical trial setting is warranted.
AB - CD19 chimeric antigen receptor (CAR) T-cell therapy represents a breakthrough for patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL), inducing sustained remissions in these patients. However, CAR T cells can result in significant toxicities. Preinfusion disease burden is associated with toxicities and outcomes after CAR T-cell therapy. We identified 33 patients with R/R DLBCL treated at 8 academic centers who had no detectable disease at the time of CAR T-cell therapy. The median time from leukapheresis to CAR T-cell infusion was 48 (19-193) days. Nine patients received axicabtagene ciloleucel, and 24 received tisagenlecleucel. There was no severe (grade ≥3) cytokine release syndrome, and only 1 patient developed severe neurotoxicity (grade 4). After a median follow-up of 16 months, 13 patients relapsed (39.4%) and 6 died (18.1%). One-year event-free survival and overall survival were 59.6% and 81.3%, respectively. Our findings suggest that, in patients with R/R DLBCL who have an indication for CAR T-cell therapy, treating patients in complete remission at the time of infusion is feasible, safe, and associated with favorable disease control. Further exploration in a larger clinical trial setting is warranted.
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U2 - 10.1182/bloodadvances.2022008294
DO - 10.1182/bloodadvances.2022008294
M3 - Article
C2 - 36355838
AN - SCOPUS:85167904304
SN - 2473-9529
VL - 7
SP - 3192
EP - 3198
JO - Blood Advances
JF - Blood Advances
IS - 13
ER -