CD19-directed CART therapy for T-cell/histiocyte–rich large B-cell lymphoma

•The 2-year progression-free survival of 58 patients with T-cell/histiocyte–rich large B-cell lymphoma treated with CD19-CART therapy was 29%. [Display omitted] T-cell/histiocyte–rich large B-cell lymphoma (THRLBCL) is a rare histologic variant of LBCL. Limited data regarding CD19–directed chimeric...

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Veröffentlicht in:Blood advances 2024-10, Vol.8 (20), p.5290-5296
Hauptverfasser: Pophali, Priyanka A., Fein, Joshua A., Ahn, Kwang W., Allbee-Johnson, Molly, Ahmed, Nausheen, Awan, Farrukh T., Farhan, Shatha, Grover, Natalie S., Hilal, Talal, Iqbal, Madiha, Maakaron, Joseph, Modi, Dipenkumar, Nasrollahi, Elham, Schachter, Levanto G., Sauter, Craig, Hamadani, Mehdi, Herrera, Alex, Shouval, Roni, Shadman, Mazyar
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Sprache:eng
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Zusammenfassung:•The 2-year progression-free survival of 58 patients with T-cell/histiocyte–rich large B-cell lymphoma treated with CD19-CART therapy was 29%. [Display omitted] T-cell/histiocyte–rich large B-cell lymphoma (THRLBCL) is a rare histologic variant of LBCL. Limited data regarding CD19–directed chimeric antigen receptor T-cell (CART) therapy in relapsed/refractory (R/R) THRLBCL suggest poor efficacy. We investigated CART outcomes for R/R THRLBCL through the Center for International Blood and Marrow Transplant Research registry. A total of 58 adult patients with R/R THRLBCL who received commercial CD19-CART therapy between 2018 and 2022 were identified. Most patients (67%) had early relapse of disease (45% primary refractory) with a median of 3 (range, 1-7) prior therapies and were treated with axicabtagene ciloleucel (69%). At median follow-up of 23 months after CART therapy, 2-year overall and progression-free survival were 42% (95% confidence interval [CI], 27-57) and 29% (95% CI, 17-43), respectively. In univariable analysis, poor performance status before CART therapy was associated with higher mortality (hazard ratio, 2.35; 95%CI, 1.02-5.5). The 2-year cumulative incidences of relapse/progression and nonrelapse mortality were 69% and 2%, respectively. Grade ≥3 cytokine release syndrome and immune effector cell–associated neurologic syndrome occurred in 7% and 15% of patients, respectively. In this largest analysis of CD19-CART therapy for R/R THRLBCL, ∼30% of patients were alive and progression free 2 years after CART therapy. Despite a high incidence of progression (69% at 2 years), these results suggest a subset of patients with R/R THRLBCL may have durable responses with CARTs.
ISSN:2473-9529
2473-9537
2473-9537
DOI:10.1182/bloodadvances.2024013863