Response rates of extra‐nodal diffuse large B cell lymphoma to anti‐CD19‐CAR T cells: A real word retrospective multicenter study

Chimeric antigen receptor T‐cells (CAR‐T) are widely used for the treatment of relapsed/refractory diffuse large B cell lymphoma (DLBCL). The data for CAR‐T cell therapy in patients with extra‐nodal (EN) lymphoma is restricted. We included 126 consecutive patients with DLBCL treated with commerciall...

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Published in:European journal of haematology 2023-07, Vol.111 (1), p.63-71
Main Authors: Beyar Katz, Ofrat, Perry, Chava, Grisariu‐Greenzaid, Sigal, Yehudai‐Ofir, Dana, Luttwak, Efrat, Avni, Batia, Zuckerman, Tsila, Sdayoor, Inbal, Stepensky, Polina, Ringelstein‐Harlev, Shimrit, Bar‐On, Yael, Libster, Diana, Sharvit, Liat, Amit, Odelia, Greenbaum, Uri, Gold, Ronit, Herishanu, Yair, Benyamini, Noam, Avivi, Irit, Ram, Ron
Format: Article
Language:English
Subjects:
B-cell lymphoma
CAR‐T cells
CD19 antigen
Cell therapy
Chimeric antigen receptors
extra‐nodal
Gastrointestinal tract
L-Lactate dehydrogenase
Lymphocytes T
Lymphoma
Medical prognosis
Patients
Pharynx
Urinary tract
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Summary:Chimeric antigen receptor T‐cells (CAR‐T) are widely used for the treatment of relapsed/refractory diffuse large B cell lymphoma (DLBCL). The data for CAR‐T cell therapy in patients with extra‐nodal (EN) lymphoma is restricted. We included 126 consecutive patients with DLBCL treated with commercially available CAR‐T cells (tisagenlecleucel, n = 100, 79.4% and axicabtagene ciloleucel, n = 26, 20.6%). At lymphodepletion, 72 of 126 (57%) patients had EN disease, 42 of 126 (33%) patients had nodal disease (ND)‐only and 12 of 126 (10%) showed no disease assessed by PET‐CT. There were no significant differences in CAR‐T related toxicities and in the median Progression free survival (PFS) between EN patients and ND (10.76 [95% CI: 7.8–13.6] vs. 14.1 [95% CI: 10–18.1] months, p = .126). Similarly, median overall survival (OS) was not significantly different (15.36 [95% CI 12.5–18.2] vs. 18.4 [95% CI 14.8–22.1] months, p = .100). Subgroup analysis according to the number of EN involved sites showed that median PFS and OS were significantly higher in patients with 2 EN sites, respectively (16.5 months [95% CI 13.4–19.6] vs. 8.7 months [95% CI 4.6–12.8], p = .05). In multivariate cox regression analysis, increased number sites of EN disease and high lactate dehydrogenase (LDH) at lymphodepletion negatively impacted PFS (p = .021 and 2 EN sites at lymphodepletion have significantly worse clinical outcomes compared to patients with
ISSN:0902-4441
1600-0609
DOI:10.1111/ejh.13968