Impact and safety of chimeric antigen receptor T-cell therapy in older, vulnerable patients with relapsed/refractory large B-cell lymphoma

Abstract

Impact and safety of chimeric antigen receptor T cell therapy in older, vulnerable patients with relapsed/refractory large B-cell lymphoma.

Evaluation of the safety and efficacy of humanized anti-CD19 chimeric antigen receptor T-cell therapy in older patients with relapsed/refractory diffuse large B-cell lymphoma based on the comprehensive geriatric assessment system

“…Compared with other studies of elderly R/R DLBCL treated with CAR Tcell therapy, our results were similar to those in younger R/R DLBCL patients [14][15][16][17][18][19]. Moreover, in older R/R DLBCL patients, the CR rate (51.6%) was similar to that in Lin et al's study (51%) [8] and inferior to that in the ZUMA-1 study (75%) [7]. The CGA grouping method showed that the ORR, CR, median PFS, and median OS in the fit group were higher than those in the unfit/frail group, suggesting that further stratification of DLBCL patients older than 65 years of age could help in the evaluation of treatment efficacy and more accurate prognosis prediction.…”

“…In ZUMA-1 [7] to R/R DLBCL patients who received CAR T-cell therapy, the CR rate in patients !65 years was higher than that of in patients <65 years (75% vs. 53%). Lin et al [8] reported 49 R/R DLBCL patients (24 patients >65 years, 25 patients <65 years) who received CAR T-cell therapy with a median follow-up of 179 days. The CR rate at 100 days was 51%, while the 6-month progression-free survival (PFS) and overall survival (OS) were 48% and 71%, respectively.…”

Critical care management of chimeric antigen receptor T‐cell therapy recipients

“…In general, given the relatively good prognosis of typical CAR T‐cell–associated adverse events, a low threshold for ICU admission is justified. Real‐world data demonstrate that appropriately selected elderly patients older than 65 years or patients with limited comorbidities can undergo CAR T‐cell therapy and achieve favorable outcomes 81 . It has been shown that delayed ICU admission is associated with decreased chances of survival 82 .…”

Age defining immune effector cell associated neurotoxicity syndromes in aggressive large B cell lymphoma patients treated with axicabtagene ciloleucel

“…3 Recently, Lin et al reported similar safety and tolerability of older patients with lymphoma treated with commercial CD19 CAR T-cells to younger patients aged 65 years old or younger. 4 Since there were only 16 patients aged older than 65 years in our cohort (eight had ICANS), we performed the primary analysis using the age cut-off of 60 years old. Secondary analysis comparing < 65 versus ≥ 65 years-old patients showed similar findings (Tables S5-S8 and Figures S5-S7).…”