Outcomes of CD19 CAR-T therapy in central nervous system lymphoma: Insights from a multicentre experience Journal Article
| Authors: | Cassanello, G.; Luttwak, E.; Brown, S.; Devlin, S. M.; Imber, B.; Ip, A.; Leslie, L. A.; Accav, N. G.; Avigdor, A.; Marcus, R.; Beyar-Katz, O.; Corona, M.; Luna De Abia, A.; Calabrese De Feo, J.; Rivas Delgado, A.; Lue, J. K.; Grommes, C.; Shah, G. L.; Park, J.; Perales, M. A.; Salles, G.; Shouval, R.; Scordo, M.; Palomba, M. L. |
| Article Title: | Outcomes of CD19 CAR-T therapy in central nervous system lymphoma: Insights from a multicentre experience |
| Abstract: | Chimeric antigen receptor (CAR) T-cell therapy has reshaped the treatment paradigm for relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). However, its role in central nervous system lymphoma (CNSL) remains uncertain. We conducted a multicentre, retrospective study on 54 adult R/R CNSL patients treated at four international institutions with commercial (axi-cel, tisa-cel, liso-cel) or a point of care (POC) CD19-CAR T-cell products. At day 100 post CAR-T infusion, 65% of patients attained a complete response as their best response in both systemic and central nervous system compartments. The median progression-free survival (PFS) was 7.5 months, with a 1-year PFS of 35%. The median overall survival (OS) was 19 months, with a 1-year OS of 63%. In multivariable analyses, CAR-T product was significantly associated with PFS (p = 0.009) and OS (p = 0.013), with patients receiving tisa-cel exhibiting poorer outcomes than axi-cel and patients receiving liso-cel or POC CAR-T product demonstrating better outcomes than axi-cel. Toxicity profiles were consistent with pivotal trials in R/R DLBCL. Grade ≥3 cytokine release syndrome occurred in 11% of patients, while grade ≥3 immune-effector cell-associated neurotoxicity syndrome was observed in 28%. Our study supports the feasibility and safety of anti-CD19 CAR-T therapy in CNSL. The specific CAR-T product infused emerged as a factor influencing outcomes. © 2025 British Society for Haematology and John Wiley & Sons Ltd. |
| Keywords: | immunotherapy; lymphoma; cellular therapies; haematological oncology |
| Journal Title: | British Journal of Haematology |
| ISSN: | 0007-1048 |
| Publisher: | John Wiley & Sons |
| Publication status: | Online ahead of print |
| Date Published: | 2025-07-01 |
| Online Publication Date: | 2025-07-01 |
| Language: | English |
| DOI: | 10.1111/bjh.20234 |
| PROVIDER: | scopus |
| PUBMED: | 40589238 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- Source: Scopus |
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