Double hit & double expressor lymphomas: a multicenter analysis of survival outcomes with CD19-directed CAR T-cell therapy
Double-hit (DHL) and double expressor (DEL) DLBCL have poor prognosis with standard therapy but CART may overcome this poor prognostic impact. In this multicenter retrospective study, we sought to confirm this observation by evaluating survival outcomes among patients with relapsed/refractory DHL and DEL treated with CART and evaluate outcomes of relapse post-CART. A total of 408 adult patients with relapsed/refractory DLBCL from 13 academic centers were included based on the availability of DHL and DEL. All 408 patients were included in the DHL (n = 80) vs non-DHL (n = 328) analysis, while 333 patients were included in the analysis of DHL (n = 80) vs DEL (n = 74) vs non (n = 179). On MVA, there were no differences for PFS for DHL vs non-DHL (HR 0.8, 95%CI 0.5-1.3, p = 0.35) or DHL vs DEL vs other (three-way p value, p = 0.5). Response rates and toxicities were similar among groups. Patients with DEL had the highest relapse rates post-CART, while DHL had the worst overall survival after CART relapse. In sum, our data support the notion that CART cell therapy can overcome the poor prognostic impact of DHL and DEL DLBCL in the relapsed/refractory setting. Additionally, patients with DHL that relapse after CART have a very poor prognosis.
Authors
- Reem Karmali (ORCID: https://orcid.org/0000-0003-0984-4376)
- Thomas A. Ollila (ORCID: https://orcid.org/0000-0003-0102-6491)
- Jane N. Winter (ORCID: https://orcid.org/0000-0001-7542-3305)
- Leo I. Gordon (ORCID: https://orcid.org/0000-0003-1666-7064)
- Geoffrey Shouse (ORCID: https://orcid.org/0000-0002-7917-5713)
- Kevin A. David (ORCID: https://orcid.org/0000-0001-7415-0376)
- Stefan Klaus Barta (ORCID: https://orcid.org/0000-0002-3280-5271)
- Vaishalee Padgaonkar Kenkre (ORCID: https://orcid.org/0009-0000-4539-9332)
- Joanna Zurko (ORCID: https://orcid.org/0000-0002-9532-4336)
- Deborah Marie Stephens (ORCID: https://orcid.org/0000-0001-9188-5008)
- Brian T. Hess (ORCID: https://orcid.org/0000-0003-0176-2050)
- Pallawi Torka (ORCID: https://orcid.org/0000-0002-1681-5883)
- Jonathan Cruz Moreira (ORCID: https://orcid.org/0009-0001-9749-7599)
- Lindsey A. Fitzgerald (ORCID: https://orcid.org/0000-0001-5988-2878)
- Rahul S. Bhansali (ORCID: https://orcid.org/0000-0002-3616-7393)
- Tamara Kay Moyo (ORCID: https://orcid.org/0000-0002-7431-8455)
- Ishan Roy (ORCID: https://orcid.org/0000-0002-9109-0421)
- Alexey Valeryevich Danilov (ORCID: https://orcid.org/0000-0003-4461-0970)
- Jason T. Romancik (ORCID: https://orcid.org/0000-0003-0054-9362)
- Shuo Ma (ORCID: https://orcid.org/0000-0002-6139-5486)
- Narendranath Epperla (ORCID: https://orcid.org/0000-0002-8216-3457)
- Barbara Pro
- Nirav Niranjan Shah (ORCID: https://orcid.org/0000-0002-4336-1071)
- Jonathon B. Cohen (ORCID: https://orcid.org/0000-0001-7696-2693)
- Bukky Florence Tabiti
Institutions
- Rutgers, The State University of New Jersey (US)
- Northwestern University (US)
- University of North Carolina at Chapel Hill (US)
- Shirley Ryan AbilityLab (US)
- Memorial Sloan Kettering Cancer Center (US)
- University of Wisconsin–Madison (US)
- Emory University (US)
- Medical University of South Carolina (US)
- Medical College of Wisconsin (US)
- University of Utah (US)
- Brown University (US)
- Columbia University Irving Medical Center (US)
- The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US)
- Huntsman Cancer Institute (US)
- MUSC Hollings Cancer Center (US)
- Levine Cancer Institute (US)
- University of Wisconsin Carbone Cancer Center (US)
- City of Hope (US)
- Lifespan (US)
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
- UNC Lineberger Comprehensive Cancer Center
- The Ohio State University (US)
- University of Pennsylvania (US)
Publication Details
- Journal
- Blood Cancer Journal
- Published
- 2025-03-26
- DOI
- https://doi.org/10.1038/s41408-025-01250-8
- Citations
- 9
- Primary Topic
- CAR-T cell therapy research
- Type
- article
- Field-Weighted Citation Impact
- 9.41