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Lookup NU author(s): Dr Tobias Menne, Dr Wendy Osborne
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© 2023 British Society for Haematology and John Wiley & Sons Ltd.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.
Author(s): Kuhnl A, Kirkwood AA, Roddie C, Menne T, Tholouli E, Bloor A, Besley C, Chaganti S, Osborne W, Norman J, Gibb A, Sharplin K, Cuadrado M, CorreiadeFarias M, Cheok K, Neill L, Latif AL, GonzalezArias C, Uttenthal B, Jones C, Johnson R, McMillan A, Sanderson R, Townsend W
Publication type: Article
Publication status: Published
Journal: British Journal of Haematology
Year: 2023
Volume: 202
Issue: 1
Pages: 65-73
Print publication date: 01/07/2023
Online publication date: 20/04/2023
Acceptance date: 31/03/2023
ISSN (print): 0007-1048
ISSN (electronic): 1365-2141
Publisher: John Wiley and Sons Inc
URL: https://doi.org/10.1111/bjh.18810
DOI: 10.1111/bjh.18810
PubMed id: 37082780
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