Titre :

Outcomes of patients with aggressive B-Cell lymphoma after failure of anti-CD19 CAR T-Cell Therapy: A DESCAR-T analysis.

Auteur(s) :

Di Blasi, R. [Auteur]
Le Gouill, S. [Auteur]
Bachy, E. [Auteur]
Cartron, G. [Auteur]
Beauvais, David [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Le Bras, F. [Auteur]
Gros, F. X. [Auteur]
Choquet, S. [Auteur]
Bories, P. [Auteur]
Feugier, P. [Auteur]
Casasnovas, O. [Auteur]
Bay, J. O. [Auteur]
Mohty, M. [Auteur]
Joris, M. [Auteur]
Gastinne, T. [Auteur]
Sesques, P. [Auteur]
Tudesq, J. J. [Auteur]
Vercellino, L. [Auteur]
Morschhauser, Franck [Auteur]
Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) - ULR 7365
Gat, E. [Auteur]
Broussais, F. [Auteur]
Houot, R. [Auteur]
Thieblemont, C. [Auteur]

Titre de la revue :

Blood

Numéro :

140

Pagination :

2584-2593

Date de publication :

2022-09-21

ISSN :

1528-0020

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Anti-CD19 chimeric antigen receptor (CAR) T-cells represent a major advance in the treatment of relapsed/refractory aggressive B-cell lymphomas. However, a significant number of patients experience failure. Among 550 ...
Lire la suite >Anti-CD19 chimeric antigen receptor (CAR) T-cells represent a major advance in the treatment of relapsed/refractory aggressive B-cell lymphomas. However, a significant number of patients experience failure. Among 550 patients registered in the French registry DESCAR-T, 238 (43.3%) experienced progression/relapse, with a median follow-up of 7.9 months. At registration, 57.0% of patients presented an age-adjusted International Prognostic Index of 2 to 3, 18.9% had Eastern Cooperative Oncology Group performance status ≥2, 57.1% received >3 lines of treatment prior to receiving CAR T-cells, and 87.8% received bridging therapy. At infusion, 66% of patients presented progressive disease, and 38.9% had high lactate dehydrogenase (LDH). Failure after CAR T-cell treatment occurred after a median of 2.7 months (range: 0.2-21.5). Fifty-four patients (22.7%) presented very early failure (day [D] 0-D30); 102 (42.9%) had early failure (D31-D90), and 82 (34.5%) had late (>D90) failure. After failure, 154 patients (64%) received salvage treatment: 38.3% received lenalidomide, 7.1% bispecific antibodies, 21.4% targeted treatment, 11% radiotherapy, and 20% immunochemotherapy with various regimens. Median progression-free survival was 2.8 months, and median overall survival (OS) was 5.2 months. Median OS for patients failing during D0-D30 vs after D30 was 1.7 vs 3.0 months, respectively (P = .0001). Overall, 47.9% of patients were alive at 6 months, but only 18.9% were alive after very early failure. In multivariate analysis, predictors of OS were high LDH at infusion, time to CAR-T failure <D30, and high C-reactive protein at infusion. This multicentric analysis confirms the poor outcome of patients relapsing after CAR T-cell treatment, highlighting the need for further strategies dedicated to this population.Lire moins >

Langue :

Anglais

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 :

2023-05-25T02:27:35Z
2023-09-15T12:41:32Z