Clinical outcomes of tisagenlecleucel in relapsed/refractory diffuse large B-cell lymphoma: insights from a single-center study

Chimeric antigen receptor (CAR) T-cell therapy has transformed the treatment landscape for relapsed and refractory large B-cell lymphoma (RR-DLBCL). This study evaluated the real-world efficacy and toxicities of 96 patients with RR-DLBCL who received tisagenlecleucel (tisa-cel) at a single institution. Among 81 patients who received bridging chemotherapy, most received a bendamustine and rituximab regimen (n = 48, 46.9%), and 31 (38.3%) responded to bridging chemotherapy (17.3% complete remission [CR] and 21.0% partial remission). Tisa-cel showed an overall response rate (ORR) of 71.9% at 1 month, which declined to 55.1% at 3 months. The median progression-free survival (PFS) was 4.5 months, with 1-year PFS at 33.3%. Median overall survival (OS) was 13.9 months, with a 1-year OS rate of 55.2%. Achieving CR at 3 months was correlated with significantly improved PFS and OS. Cytokine release syndrome occurred in 75% of patients (14.6% grade ≥ 3) and immune effector cell-associated neurotoxicity syndrome occurred in 22.9% of patients (7.3% grade ≥ 3). All adverse events were managed effectively. The results demonstrated significant survival benefits with manageable toxicities, supporting tisa-cel as a viable salvage therapy for RR-DLBCL.