CAR T in patients with large B-cell lymphoma not fit for autologous transplant
Authors
Kuhnl, A.Kirkwood, A. A.
Roddie, C.
Menne, T.
Tholouli, E.
Bloor, Adrian
Besley, C.
Chaganti, S.
Osborne, W.
Norman, J.
Gibb, Adam
Sharplin, K.
Cuadrado, M.
Correia de Farias, M.
Cheok, K.
Neill, L.
Latif, A. L.
González Arias, C.
Uttenthal, B.
Jones, C.
Johnson, R.
McMillan, A.
Sanderson, R.
Townsend, W.
Affiliation
Department of Haematology, King's College Hospital, London, UKIssue Date
2023
Metadata
Show full item recordAbstract
Large B-cell lymphoma (LBCL) patients with comorbidities and/or advanced age are increasingly considered for treatment with CD19 CAR T, but data on the clinical benefit of CAR T in the less fit patient population are still limited. We analysed outcomes of consecutive patients approved for treatment with axicabtagene ciloleucel (axi-cel) or tisagenlecleucel (tisa-cel) by the UK National CAR T Clinical Panel, according to fitness for autologous stem cell transplant (ASCT). 81/404 (20%) of approved patients were deemed unfit for ASCT. Unfit patients were more likely to receive tisa-cel versus axi-cel (52% vs. 48%) compared to 20% versus 80% in ASCT-fit patients; p < 0.0001. The drop-out rate from approval to infusion was significantly higher in the ASCT-unfit group (34.6% vs. 23.5%; p = 0.042). Among infused patients, response rate, progression-free and overall survival were similar in both cohorts. CAR T was well-tolerated in ASCT-unfit patients with an incidence of grade ≥3 cytokine release syndrome and neurotoxicity of 2% and 11%, respectively. Results from this multicentre real-world cohort demonstrate that CD19 CAR T can be safely delivered in carefully selected older patients and patients with comorbidities who are not deemed suitable for transplant.Citation
Kuhnl A, Kirkwood AA, Roddie C, Menne T, Tholouli E, Bloor A, et al. CAR T in patients with large B-cell lymphoma not fit for autologous transplant. British journal of haematology. 2023 Apr 20. PubMed PMID: 37082780. Epub 2023/04/21. eng.Journal
British Journal of HaematologyDOI
10.1111/bjh.18810PubMed ID
37082780Additional Links
https://dx.doi.org/10.1111/bjh.18810Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1111/bjh.18810