Clinical outcomes of chimeric antigen receptor T-cell therapy following autologous hematopoietic stem cell transplantation in 38 patients with refractory/relapsed primary or secondary central nervous system lymphoma
Abstract Background Several reports have indicated that chimeric antigen receptor (CAR) T-cell therapy following autologous hematopoietic stem cell transplantation (ASCT) is a promising strategy for refractory/relapsed (r/r) central nervous system lymphoma (CNSL), but the number of reported cases is...
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Springer
2024-11-01
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| Series: | Cancer Immunology, Immunotherapy |
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| Online Access: | https://doi.org/10.1007/s00262-024-03855-7 |
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| author | Jiaying Wu Wanying Liu Yang Cao Yang Yang Zhen Shang Mi Zhou Yicheng Zhang Fankai Meng Xiaojian Zhu Yi Xiao |
| author_facet | Jiaying Wu Wanying Liu Yang Cao Yang Yang Zhen Shang Mi Zhou Yicheng Zhang Fankai Meng Xiaojian Zhu Yi Xiao |
| author_sort | Jiaying Wu |
| collection | DOAJ |
| description | Abstract Background Several reports have indicated that chimeric antigen receptor (CAR) T-cell therapy following autologous hematopoietic stem cell transplantation (ASCT) is a promising strategy for refractory/relapsed (r/r) central nervous system lymphoma (CNSL), but the number of reported cases is limited. Methods The cohort in this retrospective study consisted of 38 patients with r/r CNSL who received CAR T-cell therapy following ASCT at our center between January 2019 and April 2024. Group comparisons of continuous variables were tested using the unpaired Student’s t-test or the Mann–Whitney U-test, while categorical variables were analyzed using Fisher's exact test. The Kaplan–Meier method was employed to estimate survival curves, and group comparisons were performed using the log-rank test. Results The cohort comprised 38 patients with r/r CNSL, all of whom had active CNS involvement. After therapy, the best overall response rate (ORR) of all patients was 78.9%. Subgroup analysis found that a lower ORR was observed in patients with lactate dehydrogenase levels above the upper limit of normal (60.0% vs. 91.3%, P = 0.039). With a median follow-up of 37.5 months, the estimated 1-year overall survival (OS) and progression-free survival (PFS) rates were 72.8% and 57.4%, respectively. The risk factors associated with PFS was no response to current therapy (adjusted hazard ratio: 22.87, P < 0.001). The incidence rates of severe cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome were both 13.2%. Among the 25 patients with secondary CNSL (SCNSL), the best ORRs were 91.7% for those with CNS lesions only and 61.5% for those with CNS and systemic lesions (P = 0.160), while the estimated 1-year PFS rates were 83.3% and 38.5%, respectively (P = 0.030). Conclusions CAR T-cell therapy following ASCT shows promising efficacy for r/r CNSL patients. Besides, SCNSL patients with CNS and systemic lesions have inferior treatment efficacy compared to those with CNS lesions only. |
| format | Article |
| id | doaj-art-41d050be08d44e0eb4a67339bd853d1f |
| institution | Kabale University |
| issn | 1432-0851 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Springer |
| record_format | Article |
| series | Cancer Immunology, Immunotherapy |
| spelling | doaj-art-41d050be08d44e0eb4a67339bd853d1f2025-02-02T12:26:34ZengSpringerCancer Immunology, Immunotherapy1432-08512024-11-0174111410.1007/s00262-024-03855-7Clinical outcomes of chimeric antigen receptor T-cell therapy following autologous hematopoietic stem cell transplantation in 38 patients with refractory/relapsed primary or secondary central nervous system lymphomaJiaying Wu0Wanying Liu1Yang Cao2Yang Yang3Zhen Shang4Mi Zhou5Yicheng Zhang6Fankai Meng7Xiaojian Zhu8Yi Xiao9Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Background Several reports have indicated that chimeric antigen receptor (CAR) T-cell therapy following autologous hematopoietic stem cell transplantation (ASCT) is a promising strategy for refractory/relapsed (r/r) central nervous system lymphoma (CNSL), but the number of reported cases is limited. Methods The cohort in this retrospective study consisted of 38 patients with r/r CNSL who received CAR T-cell therapy following ASCT at our center between January 2019 and April 2024. Group comparisons of continuous variables were tested using the unpaired Student’s t-test or the Mann–Whitney U-test, while categorical variables were analyzed using Fisher's exact test. The Kaplan–Meier method was employed to estimate survival curves, and group comparisons were performed using the log-rank test. Results The cohort comprised 38 patients with r/r CNSL, all of whom had active CNS involvement. After therapy, the best overall response rate (ORR) of all patients was 78.9%. Subgroup analysis found that a lower ORR was observed in patients with lactate dehydrogenase levels above the upper limit of normal (60.0% vs. 91.3%, P = 0.039). With a median follow-up of 37.5 months, the estimated 1-year overall survival (OS) and progression-free survival (PFS) rates were 72.8% and 57.4%, respectively. The risk factors associated with PFS was no response to current therapy (adjusted hazard ratio: 22.87, P < 0.001). The incidence rates of severe cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome were both 13.2%. Among the 25 patients with secondary CNSL (SCNSL), the best ORRs were 91.7% for those with CNS lesions only and 61.5% for those with CNS and systemic lesions (P = 0.160), while the estimated 1-year PFS rates were 83.3% and 38.5%, respectively (P = 0.030). Conclusions CAR T-cell therapy following ASCT shows promising efficacy for r/r CNSL patients. Besides, SCNSL patients with CNS and systemic lesions have inferior treatment efficacy compared to those with CNS lesions only.https://doi.org/10.1007/s00262-024-03855-7Central nervous system lymphomaTransplantationChimeric antigen receptorImmunotherapyClinical outcomes |
| spellingShingle | Jiaying Wu Wanying Liu Yang Cao Yang Yang Zhen Shang Mi Zhou Yicheng Zhang Fankai Meng Xiaojian Zhu Yi Xiao Clinical outcomes of chimeric antigen receptor T-cell therapy following autologous hematopoietic stem cell transplantation in 38 patients with refractory/relapsed primary or secondary central nervous system lymphoma Cancer Immunology, Immunotherapy Central nervous system lymphoma Transplantation Chimeric antigen receptor Immunotherapy Clinical outcomes |
| title | Clinical outcomes of chimeric antigen receptor T-cell therapy following autologous hematopoietic stem cell transplantation in 38 patients with refractory/relapsed primary or secondary central nervous system lymphoma |
| title_full | Clinical outcomes of chimeric antigen receptor T-cell therapy following autologous hematopoietic stem cell transplantation in 38 patients with refractory/relapsed primary or secondary central nervous system lymphoma |
| title_fullStr | Clinical outcomes of chimeric antigen receptor T-cell therapy following autologous hematopoietic stem cell transplantation in 38 patients with refractory/relapsed primary or secondary central nervous system lymphoma |
| title_full_unstemmed | Clinical outcomes of chimeric antigen receptor T-cell therapy following autologous hematopoietic stem cell transplantation in 38 patients with refractory/relapsed primary or secondary central nervous system lymphoma |
| title_short | Clinical outcomes of chimeric antigen receptor T-cell therapy following autologous hematopoietic stem cell transplantation in 38 patients with refractory/relapsed primary or secondary central nervous system lymphoma |
| title_sort | clinical outcomes of chimeric antigen receptor t cell therapy following autologous hematopoietic stem cell transplantation in 38 patients with refractory relapsed primary or secondary central nervous system lymphoma |
| topic | Central nervous system lymphoma Transplantation Chimeric antigen receptor Immunotherapy Clinical outcomes |
| url | https://doi.org/10.1007/s00262-024-03855-7 |
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