Relapsed/refractory diffuse large B-cell lymphoma patients. A multicenter retrospective analysis of eligibility criteria for car-T cell therapy. Issue 4 (21st March 2021)

• Record Type: Journal Article
• Authors: Di Rocco, Alice; Cuneo, Antonio; Di Rocco, Arianna; Merli, Francesco; De Luca, Giulia; Petrucci, Luigi; Ansuinelli, Michela; Penna, Domenico; Rotondo, Francesco; Rigolin, Gian Matteo; Giaimo, Mariateresa; Re, Francesca; Farcomeni, Alessio; Martelli, Maurizio; Foà, Robin
• Is Part Of: Leukemia & lymphoma. Volume 62:Issue 4(2021)
• Page Start: 828
• Page End: 836
• Publication Date: 2021-03-21
• Subjects: Diffuse large B-cell lymphoma -- CAR-T cells -- relapse-refractory disease -- CAR-T cell eligibility; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2020.1849676
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Anti-CD19 chimeric antigen receptor (CAR) T cells represent the first approved third-line therapy associated with long-term remissions in patients with refractory/relapsed (R/R) diffuse large B-cell lymphoma (DLBCL). Eligibility criteria to identify patients who can successfully receive CAR-T are still debated. For this reason, the aim of this study was to identify factors influencing eligibility and define a realistic patient estimate. Of 1100 DLBCL patients, 137 were included. Based on the Juliet trial inclusion criteria, only 64 patients (46.7%) would be eligible. Median overall survival (OS) was 8.04 months in eligible vs 3.23 in non-eligible patients ( p < 0.001). Multivariate analysis identified stage III-IV ( p = 0.017) and ECOG ≥ 2 ( p < 0.001) as significant independent prognostic factors for OS. Moreover, only 64/1100 (5.8%) DLBCL patients would be truly eligible for CAR-T. Our real-life data confirm that with a longer waiting time patients with advanced stage and poor ECOG are less likely to be eligible for CAR-T cell infusion.