<scp>CD19 CAR</scp> T‐Cell Therapy for Primary Mediastinal Large B‐Cell Lymphoma: A <scp>CIBMTR</scp> Analysis

T cells engineered with CD19-directed chimeric antigen receptors (CD19 CAR) T cells have become standard treatment for patients with high risk, relapsed or refractory (R/R) large B-cell lymphomas (LBCL). However, outcomes in patients with rare subsets of LBCL, such as primary mediastinal large B-cell lymphoma (PBMCL), have not been well characterized. The impact of prior immune checkpoint inhibitor (ICI) treatment, commonly used to treat R/R PMBCL, is also unknown. To address these gaps, we retrospectively analyzed CIBMTR registry data including PMBCL patients undergoing CD19 CAR T-cell therapy per standard-of-care. A total of 135 PMBCL adults from 66 centers were included. Median age at the time of CAR T-cell therapy was 32. Thirty-nine patients (28.9%) had received an ICI prior to CAR T-cell therapy. The best overall and complete response (CR) rates after CD19 CAR T-cell therapy were 79% and 67.7%, respectively. The 2-year progression-free (PFS) and overall survival (OS) were 58.6% (95% CI, 49.7-67.3) and 80.8% (95% CI, 72.6-87.8), respectively. The 2-year cumulative incidence (CI) of relapse and non-relapse mortality (NRM) were 36% (95% CI, 27.8-44.7) and 5.4% (95% CI, 1.9-10.5), respectively. We observed grade ≥ 3 CRS and ICANS in 6.1% and 14.7%, respectively. Prior ICI exposure was associated with lower 2-year CI of relapse (ICI-exposed, 21.7%; ICI-naïve, 41.6%; p = 0.03) and higher 2-year NRM (ICI-exposed, 11.7%; ICI-naïve, 2.8%; p = 0.03). We could not confirm statistically different PFS (p = 0.19) or OS (p = 0.26) between ICI-exposed and ICI-naïve patients. CD19 CAR T-cell therapy led to high rates of durable responses in PMBCL patients with low rates of severe toxicities.

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Publication Details

Journal
American Journal of Hematology
Published
2025-08-11
DOI
https://doi.org/10.1002/ajh.70033
Citations
1
Primary Topic
CAR-T cell therapy research
Type
article
Field-Weighted Citation Impact
1.05

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article

CD19 CAR T‐Cell Therapy for Primary Mediastinal Large B‐Cell Lymphoma: A CIBMTR Analysis

Kwang Woo Ahn, Mitchell Stuart Cairo, Melhem Solh, Laurie K. Pearson et al.
1 citations
American Journal of Hematology
CAR-T cell therapy research
1.05
article

CD19 CAR T‐Cell Therapy for Primary Mediastinal Large B‐Cell Lymphoma: A CIBMTR Analysis

Kwang Woo Ahn, Mitchell Stuart Cairo, Melhem Solh, Laurie K. Pearson, Jordan Gauthier, Attaphol Pawarode, Julio Delgado, Kitsada Wudhikarn, Yago L. Nieto, Alex Francisco Herrera, Marcos de Lima, Aung M. Tun, Qinghua Lian, Mazyar Shadman, Alberto Mussetti, Jinalben Patel, Adriana K. Malone, Sherif M. Badawy, Bradley Haverkos, Natalie Sophia Grover, Anna Sureda, Samuel Yamshon, Cameron J. Turtle, Mehdi Hamadani
article en
1 citations

Abstract

T cells engineered with CD19-directed chimeric antigen receptors (CD19 CAR) T cells have become standard treatment for patients with high risk, relapsed or refractory (R/R) large B-cell lymphomas (LBCL). However, outcomes in patients with rare subsets of LBCL, such as primary mediastinal large B-cell lymphoma (PBMCL), have not been well characterized. The impact of prior immune checkpoint inhibitor (ICI) treatment, commonly used to treat R/R PMBCL, is also unknown. To address these gaps, we retrospectively analyzed CIBMTR registry data including PMBCL patients undergoing CD19 CAR T-cell therapy per standard-of-care. A total of 135 PMBCL adults from 66 centers were included. Median age at the time of CAR T-cell therapy was 32. Thirty-nine patients (28.9%) had received an ICI prior to CAR T-cell therapy. The best overall and complete response (CR) rates after CD19 CAR T-cell therapy were 79% and 67.7%, respectively. The 2-year progression-free (PFS) and overall survival (OS) were 58.6% (95% CI, 49.7-67.3) and 80.8% (95% CI, 72.6-87.8), respectively. The 2-year cumulative incidence (CI) of relapse and non-relapse mortality (NRM) were 36% (95% CI, 27.8-44.7) and 5.4% (95% CI, 1.9-10.5), respectively. We observed grade ≥ 3 CRS and ICANS in 6.1% and 14.7%, respectively. Prior ICI exposure was associated with lower 2-year CI of relapse (ICI-exposed, 21.7%; ICI-naïve, 41.6%; p = 0.03) and higher 2-year NRM (ICI-exposed, 11.7%; ICI-naïve, 2.8%; p = 0.03). We could not confirm statistically different PFS (p = 0.19) or OS (p = 0.26) between ICI-exposed and ICI-naïve patients. CD19 CAR T-cell therapy led to high rates of durable responses in PMBCL patients with low rates of severe toxicities.

American Journal of HematologyVol. 100(10)
Northside Hospital (US), University of North Carolina at Chapel Hill (US), The University of Sydney (AU), City Of Hope National Medical Center (US), The University of Texas MD Anderson Cancer Center (US), University of Kansas (US), Chulalongkorn University (TH), University of Washington (US), Medical College of Wisconsin (US), Cornell University (US), University of Michigan (US), Royal North Shore Hospital (AU), Fred Hutch Cancer Center (US), Maria Fareri Children's Hospital (US), Institut Català d'Oncologia (ES), Michigan Medicine (US), Hospital Clínic de Barcelona (ES), Versiti Blood Center of Wisconsin (US), Lurie Children's Hospital (US), Tisch Hospital (US), UMass Memorial Medical Center (US), Weill Cornell Medicine (US), The Ohio State University (US), University of Colorado Denver (US), Icahn School of Medicine at Mount Sinai (US)
Amgen, Bristol-Myers Squibb, Pfizer, Astellas Pharma US, Sanofi, Gilead Sciences, Alexion Pharmaceuticals, Celgene, Novartis Pharmaceuticals Corporation, CSL Behring, StemCyte, Regeneron Pharmaceuticals, Actinium Pharmaceuticals, Jazz Pharmaceuticals, Angiocrine Bioscience, bluebird bio, Incyte, Omeros Corporation, Kiadis Pharma, Astellas Pharma, Servier, Health Resources and Services Administration, Genentech, Takeda Oncology, Sanofi Genzyme, Pharmacyclics, Legend Biotech, National Heart, Lung, and Blood Institute, Office of Naval Research, National Cancer Institute, National Institute of Allergy and Infectious Diseases, Daiichi Sankyo Europe
Good health and well-being
Openalex Percentile: Top 19%
CAR-T cell therapy research
1.05
DOIOpen Access PDFOpenAlex
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