Titre :

Transfusion needs after CAR T-cell therapy for large B-cell lymphoma: predictive factors and outcome. A DESCAR-T study.

Auteur(s) :

Vic, S. [Auteur]
Thibert, J. B. [Auteur]
Bachy, E. [Auteur]
Cartron, G. [Auteur]
Gastinne, T. [Auteur]
Morschhauser, Franck [Auteur]
Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) - ULR 7365
Le Bras, F. [Auteur]
Bouabdallah, K. [Auteur]
Despas, F. [Auteur]
Bay, J. O. [Auteur]
Rubio, M. T. [Auteur]
Mohty, M. [Auteur]
Casasnovas, O. [Auteur]
Choquet, S. [Auteur]
Castilla-Llorente, C. [Auteur]
Guidez, S. [Auteur]
Loschi, M. [Auteur]
Guffroy, B. [Auteur]
Carras, S. [Auteur]
Drieu La Rochelle, L. [Auteur]
Guillet, M. [Auteur]
Houot, R. [Auteur]

Titre de la revue :

Blood Advances

Nom court de la revue :

Blood Adv

Numéro :

8

Pagination :

1573–1585

Date de publication :

2024-03-26

ISSN :

2473-9537

Résumé en anglais : [en]

Chimeric antigen receptor (CAR) T-cells targeting CD19 have been approved for the treatment of relapse/refractory large B-cell lymphoma. Hematotoxicity is the most frequent CAR T-cell–related adverse event. Transfusion ...
Lire la suite >Chimeric antigen receptor (CAR) T-cells targeting CD19 have been approved for the treatment of relapse/refractory large B-cell lymphoma. Hematotoxicity is the most frequent CAR T-cell–related adverse event. Transfusion support is a surrogate marker of severe cytopenias. Transfusion affects patients’ quality of life, presents specific toxicities, and is known to affect immunity through the so-called transfusion-related immunomodulation that may affect CAR T-cell efficacy. We analyzed data from 671 patients from the French DESCAR-T registry for whom exhaustive transfusion data were available. Overall, 401 (59.8%) and 378 (56.3%) patients received transfusion in the 6-month period before and after CAR T-cell infusion, respectively. The number of patients receiving transfusion and the mean number of transfused products increased during the 6-month period before CAR T-cell infusion, peaked during the first month after infusion (early phase), and decreased over time. Predictive factors for transfusion at the early phase were age >60 years, ECOG PS ≥2, treatment with axicabtagene ciloleucel, pre–CAR T-cell transfusions, and CAR-HEMATOTOX score ≥2. Predictive factors for late transfusion (between 1 and 6 months after infusion) were pre–CAR T-cell transfusions, CAR-HEMATOTOX score ≥2, ICANS ≥3 (for red blood cells [RBC] transfusion), and tocilizumab use (for platelets transfusion). Early transfusions and late platelets (but not RBC) transfusions were associated with a shorter progression-free survival and overall survival. Lymphoma-related mortality and nonrelapse mortality were both increased in the transfused population. Our data shed light on the mechanisms of early and late cytopenia and on the potential impact of transfusions on CAR T-cell efficacy and toxicity.Lire moins >

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
CHU Lille

Collections :

• Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) - ULR 7365

Date de dépôt :

2024-01-18T22:00:30Z
2024-06-10T12:47:49Z