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<p>Older patients with lymphoma are typically underrepresented in clinical trials with chimeric antigen receptor T cell (CAR T) therapy. In this multicenter, observational study we aimed to assess the safety and efficacy of standard CD19 CAR T in patients 80 years&#xa0;of age or older. At total of 88 patients, median age 82 (range, 80-89) years, were included. Diffuse large B cell lymphoma (DLBCL) (<i>N</i> = 60, 68.2%) represented the most common histology. Patients were treated mostly with axicabtagene ciloleucel (<i>N</i> = 41, 46.6%) followed by lisocabtagene maraleucel (<i>N</i> = 25, 28.4%). Cytokine release syndrome (CRS) (any grade) was seen in 68 (77.3%) and 51 (58%) developed immune effector cell-associated neurotoxicity syndrome (ICANS). Incidence of grade 3-4 CRS and ICANS were 7.4% and 31.4%, respectively. For patients with DLBCL/tFL, the 1-year NRM, relapse, PFS, and OS were 11.6%, 40.8%, 47.6%, and 61.2%, respectively. We conclude that CAR T is feasible and effective in patients 80 years or older with B cell lymphomas. These patients must be provided the opportunity to be evaluated for this curative approach.</p>

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Chimeric antigen receptor T cell therapy in octogenarians with B cell lymphoma: a real-world US multicenter collaborative study

  • 期刊论文

  • 发表日期：

    2025年3月1日

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  • Mohamed A. Kharfan-Dabaja,
  • Razan Mohty,
  • Neela Easwar,
  • Patrick Johnston,
  • Madiha Iqbal,
  • Narendranath Epperla,
  • Jean Yared,
  • Nausheen Ahmed,
  • Mehdi Hamadani,
  • Amer Beitinjaneh,
  • Mayur Narkhede,
  • Deepa Jagadeesh,
  • Praveen Ramakrishnan Geethakumari,
  • Bhagirathbhai Dholaria,
  • Usama Gergis,
  • Javier Munoz,
  • Jose Sandoval-Sus,
  • Frederick L. Locke,
  • Joshua Fein,
  • Arushi Khurana,
  • Ernesto Ayala,
  • Kaitlin Annunzio,
  • Aaron P. Rapoport,
  • Forat Lutfi,
  • Othman Salim Akhtar,
  • Lazaros Lekakis,
  • Amitkumar Mehta,
  • Olalekan O. Oluwole,
  • Jennifer Logue,
  • Michael D. Jain,
  • Tsiporah Shore,
  • Urshila Durani,
  • Muhamad Alhaj Moustafa,
  • Joseph McGuirk,
  • Yi Lin,
  • Samuel Yamshon,
  • Julio C. Chavez

摘要

Older patients with lymphoma are typically underrepresented in clinical trials with chimeric antigen receptor T cell (CAR T) therapy. In this multicenter, observational study we aimed to assess the safety and efficacy of standard CD19 CAR T in patients 80 years of age or older. At total of 88 patients, median age 82 (range, 80-89) years, were included. Diffuse large B cell lymphoma (DLBCL) (N = 60, 68.2%) represented the most common histology. Patients were treated mostly with axicabtagene ciloleucel (N = 41, 46.6%) followed by lisocabtagene maraleucel (N = 25, 28.4%). Cytokine release syndrome (CRS) (any grade) was seen in 68 (77.3%) and 51 (58%) developed immune effector cell-associated neurotoxicity syndrome (ICANS). Incidence of grade 3-4 CRS and ICANS were 7.4% and 31.4%, respectively. For patients with DLBCL/tFL, the 1-year NRM, relapse, PFS, and OS were 11.6%, 40.8%, 47.6%, and 61.2%, respectively. We conclude that CAR T is feasible and effective in patients 80 years or older with B cell lymphomas. These patients must be provided the opportunity to be evaluated for this curative approach.