Impact of age on outcomes after CD19 CAR T-cell therapy for large B-cell lymphomas
Year: 2025
Type: article
Study design: Observational Study
Abstract: Age may influence clinical outcomes after CD19-directed chimeric antigen receptor T cell (CAR-T) therapy. Real-world data on the survival and toxicity outcomes of older patients receiving CAR T-cell therapy are limited. We used data from Center for International Blood and Marrow Transplant Research (CIBMTR) for adults with diffuse large B-cell lymphoma who received a CAR-T from May 2018 to June 2020. Cumulative incidence and severity of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) were reported. Efficacy and safety outcomes were assessed using age as a continuous variable and amongst four age groups: 18-54, 55-64, 65-74, and ≥75 years. Nearly half (44%) of 1916 total recipients were aged 65 or older. Patients received either axicabtagene ciloleucel (75%) or tisagenlecleucel (25%). Overall rates of CRS and ICANS were 75% and 43%, and severe rates of CRS and ICANS were 9% and 21%, respectively. For all patients, 12-month OS, PFS, and relapse rates were 62%, 42%, 55%, respectively. As a continuous variable, older age did not affect OS, PFS and CRS. Risk of ICANS increased with age (hazard ratio [HR], 1.03; P < .001). Beyond age 64, risk for ICANS increases (HR, 1.65; 95% CI, 1.33-2.1; P < .001). In a categorical analysis, the 65-74 age group had lower relapse risk (HR, 0.77; 95% CI, 0.64-0.93; P = .005) than younger patients. CD19 CAR-T therapy is effective for older adults, and older age does not worsen mortality. Older age is associated with higher ICANS risk and should guide patient selection.
Source: Blood Neoplasia
Authors: Abu-Sayeef Mirza, Chitra Hosing, Francine Foss, Soyoung Kim, Amy Moskop, Temitope Oloyede, Muhammad Bilal Abid, Aimaz Afrough, Sairah Ahmed, Talha Badar, Pere Barba, Vijaya Raj Bhatt, Valerie I. Brown, Saurabh Dahiya, Abhinav Deol, Narendranath Epperla, Siddhartha Ganguly, Natalie S. Grover, Hamza Hashmi, Shahrukh Hashmi, Peiman Hematti, Gerhard C. Hildebrandt, John M. Hill, Nasheed M. Hossain, Uroosa Ibrahim, P. Connor Johnson, Mohamed A. Kharfan-Dabaja, Maxwell M. Krem, Lazaros J. Lekakis, Richard T. Maziarz, Hemant S. Murthy, Peter A. Riedell, María Queralt Salas, Geoffrey Shouse, Christopher Strouse, Monica S. Thakar, Cameron J. Turtle, Ann Woolfrey, Kitsada Wudhikarn, Jean A. Yared, Marcelo C. Pasquini, Lohith Gowda
Institutions: Moffitt Cancer Center, The University of Texas MD Anderson Cancer Center, Yale Cancer Center, Yale University, Medical College of Wisconsin, Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Mayo Clinic, Mayo Clinic in Florida, Universitat Autònoma de Barcelona, Vall d'Hebron Hospital Universitari, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Pennsylvania State University, Penn State Health Children's Hospital, Penn State Milton S. Hershey Medical Center, Stanford Medicine, Stanford Cancer Institute, Stanford University, Wayne State University, The Barbara Ann Karmanos Cancer Institute, University of Utah, Huntsman Cancer Institute, Houston Methodist, University of North Carolina at Chapel Hill, UNC Lineberger Comprehensive Cancer Center, Memorial Sloan Kettering Cancer Center, Khalifa University of Science and Technology, Sheikh Shakhbout Medical City, University of Missouri, Dartmouth–Hitchcock Medical Center, Dartmouth Health, Dartmouth Cancer Center, University of Pennsylvania, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, Harvard University, Massachusetts General Hospital, Research Medical Center, Kansas City VA Medical Center, University of Miami Hospital, Sylvester Comprehensive Cancer Center, Oregon Health & Science University, OHSU Knight Cancer Institute, University of Chicago, Hospital Clínic de Barcelona, City Of Hope National Medical Center, University of Iowa, University of Washington, Fred Hutch Cancer Center, The University of Sydney, Chulalongkorn University, University of Maryland, Baltimore, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center
Language: English
Topic: CAR-T cell therapy research
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,000
OpenAlex ID: W7106576933