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Lookup NU author(s): Dr Wendy Osborne, Dr Tom Creasey, Dr Tobias Menne
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© 2026 The Author(s). HemaSphere published by John Wiley & Sons Ltd on behalf of European Hematology Association.Following approval of axicabtagene ciloleucel (axi-cel) as second-line (2 L) treatment for large B-cell lymphoma (LBCL), results from real-world CAR T cohorts will be key to confirm safety and efficacy in standard practice. We present comprehensive clinical outcomes of LBCL patients intended to be treated with 2 L axi-cel through the UK National CAR T service. Of 345 patients approved for 2 L axi-cel, 302 (87.5%) were infused. The median age was 62 years (range 22–78); 21% were over 70 years. 75% of patients were approved for CAR T within 3 months from end of first-line (1 L) therapy. 42% of patients required pre-apheresis holding therapy, and 97% received bridging therapy. The best overall response rate was 86% (64% complete response). The 12-month OS was 73.9% (95% CI: 68.3–78.7) for infused patients and 1.5 months (0.9–3.0) for patients not proceeding to CAR T. The 12-month PFS was 52.4% (46.3–58.0). In multivariable analysis, advanced stage, male sex, no response to 1 L therapy, high LDH, and high CRP pre-infusion were independently associated with PFS. Grade ≥3 CRS and ICANS rates were 5% and 18%, respectively. Outcomes in patients aged ≥70 years were similar to the younger population. In this large UK real-world cohort of 2 L axi-cel in LBCL, we demonstrate efficacy and toxicity outcomes comparable to the pivotal ZUMA-7 trial, despite 42% patients requiring urgent holding therapy. Outcomes were favorable in patients aged ≥70 years, supporting the use of 2 L CAR T in older fit patients.
Author(s): Kuhnl A, Kirkwood AA, Northend M, Besley C, Uttenthal B, Norman J, Hiew H, Seymour F, Maybury B, Osborne W, Sillito F, Abdulgawad A, Jones C, McCarthy P, Panopoulou A, Gribben JG, Bataillard E, Martinez-Calle N, Gajendran L, O'Reilly M, Kumar E, Wilson RP, Kasivisvanathan S, Fadlelmula N, Pryce A, Awofisayo O, Maraj A, Townsend W, Cwynarski K, Paneesha S, Mathew A, Dulobdas V, El-Sharkawi D, Creasey T, Warren M, Malladi R, Owen M, Waraich M, Ediriwickrema K, Froggatt J, Delaney A, Davies AJ, Alajangi R, Collins GP, Sanderson R, Roddie C, Menne T, Chaganti S
Publication type: Article
Publication status: Published
Journal: HemaSphere
Year: 2026
Volume: 10
Issue: 2
Online publication date: 19/02/2025
Acceptance date: 17/12/2025
Date deposited: 02/03/2026
ISSN (print): 2572-9241
ISSN (electronic): 2572-9241
Publisher: John Wiley and Sons Inc
URL: https://doi.org/10.1002%2Fhem3.70312
DOI: 10.1002/hem3.70312
Data Access Statement: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. Deidentified clinical data can be made available upon request to the corresponding author
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