Chimeric antigen receptor T-cell infusion for large B-cell lymphoma in complete remission: a center for international blood and marrow transplant research analysis.

Wang, Trent P; Ahn, Kwang W; Shadman, Mazyar; Kaur, Manmeet; Ahmed, Nausheen; Bacher, Vera; Cerny, Jan; Chen, Andy; Epperla, Narendranath; Frigault, Matthew; Grover, Natalie; Haverkos, Bradley; Hill, Brian; Hossain, Nasheed; Iqbal, Madiha; Jain, Tania; Krem, Maxwell M; Maakaron, Joseph; Modi, Dipenkumar; Alhaj Moustafa, Muhamad; ... (2024). Chimeric antigen receptor T-cell infusion for large B-cell lymphoma in complete remission: a center for international blood and marrow transplant research analysis. Leukemia, 38(7), pp. 1564-1569. Springer Nature 10.1038/s41375-024-02242-6

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CD19 CAR T-cell (CAR-T) therapy is commonly administered to patients with relapsed or refractory large B-cell lymphomas (LBCL), but salvage or bridging therapy can sometimes lead to a complete response (CR) prior to infusion. Limited studies have assessed the outcomes of patients infused in CR. A total of 134 patients with LBCL in CR prior to CAR-T infusion were identified from the CIBMTR registry, with median prior lines of therapy of 3 (range 2-9). At two years post-infusion, the probability of progression-free survival was 43.5% (95% CI 34.4-52.8) and the probability of overall survival was 63.8% (95% CI 54.4-72.6). The cumulative incidence rates of non-relapse mortality and relapse/progression at two years were 9.2% (95% CI 4.5-15.4) and 47.3% (95% CI 38.2-56.6), respectively. The rate of grade 3 or higher cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) were 2.2% and 8.2%, respectively. In summary, CAR-T in heavily pretreated patients with LBCL who are in CR following two or more lines of prior therapy demonstrate that a subset of patients may remain free of progression at two years. Additionally, the toxicity profile was impressive with very low rates of grade 3 CRS and ICANS.

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