Elevated LDH greater than 400 U/L portends poorer overall survival in diffuse large B-cell lymphoma patients treated with CD19 CAR-T cell therapy in a real world multi-ethnic cohort

Anti-CD19 chimeric antigen receptor T-cell therapies have shown striking clinical activity in diffuse large B-cell lymphoma but robust biomarkers predictive of responsiveness are still needed. We treated a multi-ethnic cohort of 31 diffuse large B-cell lymphoma patients with axicabtagene ciloleucel...

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Published in:Experimental hematology & oncology 2021-12, Vol.10 (1), p.1-55, Article 55
Main Authors: Rabinovich, Emma, Pradhan, Kith, Sica, R. Alejandro, Bachier-Rodriguez, Lizamarie, Mantzaris, Ioannis, Kornblum, Noah, Shastri, Aditi, Gritsman, Kira, Goldfinger, Mendel, Verma, Amit, Braunschweig, Ira
Format: Article
Language:English
Subjects:
Antigens
Biomarkers
CAR T-cell therapy
Clinical trials
Consortia
Cytokines
Dehydrogenases
DLBCL
LDH
Letter to the Editor
Lymphoma
Medical prognosis
Multivariate analysis
Non-Hodgkin's lymphomas
Patient outcomes
Patients
T cells
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Summary:Anti-CD19 chimeric antigen receptor T-cell therapies have shown striking clinical activity in diffuse large B-cell lymphoma but robust biomarkers predictive of responsiveness are still needed. We treated a multi-ethnic cohort of 31 diffuse large B-cell lymphoma patients with axicabtagene ciloleucel with an overall response rate of 71%. Analysis of various biomarkers identified a significant decrease in overall survival with elevated lactate dehydrogenase, measured both at time of cell infusion and before lymphodepletion. Lactate dehydrogenase was prognostic in a multivariate analysis [HR = 1.47 (1.1-2.0)] and a value of 400 U/L at time of infusion and a value of 440 U/L before lymphodepletion provided the best prognostic cutoffs for overall survival in our cohort. These data demonstrate efficacy of anti-CD19 chimeric antigen receptor T-cell therapy in a diverse inner city population and demonstrate novel lactate dehydrogenase cutoffs as prognostic biomarkers. Keywords: CAR T-cell therapy, DLBCL, LDH
ISSN:2162-3619
2162-3619
DOI:10.1186/s40164-021-00248-9