Details

Autor(en) / Beteiligte

• Kuhnl, A.
• Kirkwood, A. A.
• Roddie, C.
• Menne, T.
• Tholouli, E.
• Bloor, A.
• Besley, C.
• Chaganti, S.
• Osborne, W.
• Norman, J.
• Gibb, A.
• 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.

Titel

CAR T in patients with large B‐cell lymphoma not fit for autologous transplant

Ist Teil von

• British journal of haematology, 2023-07, Vol.202 (1), p.65-73

Ort / Verlag

England: Blackwell Publishing Ltd

Erscheinungsjahr

2023

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• Summary 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.