Pre–CAR-T B-cell–directed immunotherapy exposure and outcomes after CD19 CAR-T for large B-cell lymphoma: An EBMT registry analysis
CD19-directed chimeric antigen receptor T-cell therapy (CAR-T) is standard-of-care second-line treatment for relapsed or refractory large B-cell lymphoma (LBCL) [ 1 , 2 , 3 ]. Bispecific antibodies (BSA) and polatuzumab vedotin (pola) are increasingly used prior to CAR-T, but the impact of such exposure, particularly before leukapheresis, when therapies may affect T-cell collection and fitness, remains unclear [ 4 , 5 , 6 , 7 ]. We identified 1158 patients from 38 centers undergoing licensed CD19-directed CAR-T therapy (axicabtagene ciloleucel [axi-cel] or tisagenlecleucel [tisa-cel]) between January 2018 and July 2023 from the European Society for Blood and Marrow Transplantation (EBMT) registry (Table S1 , Fig. S1 ). Pre–CAR-T B-cell–directed immunotherapy (BCDI) was defined as exposure to bispecific antibodies, polatuzumab-based regimens, or other B-cell–directed agents excluding rituximab. Overall survival (OS) was the primary endpoint and outcomes were analyzed using multivariable Cox regression models adjusted for clinically relevant covariates.
Authors
- Maria‐Luisa Schubert (ORCID: https://orcid.org/0009-0000-7853-4465)
- Norbert Schmitz (ORCID: https://orcid.org/0000-0003-4938-7528)
- Barbara Dreta
- Avichai Shimoni (ORCID: https://orcid.org/0000-0001-8782-6160)
- Wolfgang Andreas Bethge (ORCID: https://orcid.org/0000-0001-6052-2618)
- Tobias A.W. Holderried (ORCID: https://orcid.org/0000-0002-2474-523X)
- Almudena Cabero
- David Beauvais (ORCID: https://orcid.org/0000-0003-1866-828X)
- Lucas Mix (ORCID: https://orcid.org/0000-0001-5707-7840)
- Philipp Berning (ORCID: https://orcid.org/0000-0002-4152-0366)
- Ulf Schnetzke (ORCID: https://orcid.org/0000-0001-7455-8988)
- Andreas Riedel (ORCID: https://orcid.org/0000-0003-3091-7373)
- Christophe Peczynski (ORCID: https://orcid.org/0000-0002-3829-0088)
- Ron Ram (ORCID: https://orcid.org/0000-0001-8683-6930)
- Lucía López‐Corral (ORCID: https://orcid.org/0000-0003-1908-5596)
- Jan C. Schroeder (ORCID: https://orcid.org/0000-0001-7000-4427)
- Robin Noël (ORCID: https://orcid.org/0000-0002-7048-5491)
- Daniela Taurino (ORCID: https://orcid.org/0009-0009-0276-8295)
- Olaf Penack (ORCID: https://orcid.org/0000-0003-4876-802X)
- Eugenio Galli (ORCID: https://orcid.org/0000-0002-2839-916X)
- Urban Novak (ORCID: https://orcid.org/0000-0001-7642-2101)
- Bjoern Chapuy (ORCID: https://orcid.org/0000-0002-6485-8773)
- Peter Vandenberghe (ORCID: https://orcid.org/0000-0003-4719-1935)
- Robin Sanderson (ORCID: https://orcid.org/0000-0003-4915-2833)
- Claudia Lengerke (ORCID: https://orcid.org/0000-0001-5442-2805)
- Ralph Wäsch (ORCID: https://orcid.org/0000-0002-0813-3444)
- Maxime Delforge
- Eva Michel
- Fizza Imran
- Malte von Bonin
- On behalf of the GoCART Coalition
Institutions
- Humanitas University (IT)
- University Hospital Centre Zagreb (HR)
- Medical University of Graz (AT)
- Heidelberg University (DE)
- University Hospital Bonn (DE)
- Tel Aviv Sourasky Medical Center (IL)
- Sheba Medical Center (IL)
- Universitair Ziekenhuis Leuven (BE)
- University Hospital of Bern (CH)
- University Medical Center Freiburg (DE)
- University Hospital Heidelberg (DE)
- Agostino Gemelli University Polyclinic (IT)
- Centre Hospitalier Universitaire de Lille (FR)
- Lille’s Cardiology Hospital (FR)
- German Cancer Society (DE)
- University Hospital Münster (DE)
- University Children's Hospital Tübingen (DE)
- Long Term Care Community Coalition (US)
- Jena University Hospital (DE)
- King's College Hospital (GB)
- University Hospital Carl Gustav Carus (DE)
- European Society for Blood and Marrow Transplantation (FR)
- IRCCS Humanitas Research Hospital (IT)
- Charité - Universitätsmedizin Berlin (DE)
- University of Tübingen (DE)
Publication Details
- Journal
- Bone Marrow Transplantation
- Published
- 2026-09-01
- DOI
- https://doi.org/10.1038/s41409-026-02979-x
- Primary Topic
- CAR-T cell therapy research
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Deutsche Forschungsgemeinschaft
- Eberhard Karls Universität Tübingen