PMID- 37082780
OWN - NLM
STAT- MEDLINE
DCOM- 20230627
LR  - 20230627
IS  - 1365-2141 (Electronic)
IS  - 0007-1048 (Linking)
VI  - 202
IP  - 1
DP  - 2023 Jul
TI  - CAR T in patients with large B-cell lymphoma not fit for autologous transplant.
PG  - 65-73
LID - 10.1111/bjh.18810 [doi]
AB  - Large B-cell lymphoma (LBCL) patients with comorbidities and/or advanced age are 
      increasingly considered for treatment with CD19 CAR T, but data on the clinical 
      benefit of CAR T in the less fit patient population are still limited. We 
      analysed outcomes of consecutive patients approved for treatment with 
      axicabtagene ciloleucel (axi-cel) or tisagenlecleucel (tisa-cel) by the UK 
      National CAR T Clinical Panel, according to fitness for autologous stem cell 
      transplant (ASCT). 81/404 (20%) of approved patients were deemed unfit for ASCT. 
      Unfit patients were more likely to receive tisa-cel versus axi-cel (52% vs. 48%) 
      compared to 20% versus 80% in ASCT-fit patients; p < 0.0001. The drop-out rate 
      from approval to infusion was significantly higher in the ASCT-unfit group (34.6% 
      vs. 23.5%; p = 0.042). Among infused patients, response rate, progression-free 
      and overall survival were similar in both cohorts. CAR T was well-tolerated in 
      ASCT-unfit patients with an incidence of grade >/=3 cytokine release syndrome and 
      neurotoxicity of 2% and 11%, respectively. Results from this multicentre 
      real-world cohort demonstrate that CD19 CAR T can be safely delivered in 
      carefully selected older patients and patients with comorbidities who are not 
      deemed suitable for transplant.
CI  - (c) 2023 British Society for Haematology and John Wiley & Sons Ltd.
FAU - Kuhnl, A
AU  - Kuhnl A
AUID- ORCID: 0000-0002-4952-2550
AD  - Department of Haematology, King's College Hospital, London, UK.
FAU - Kirkwood, A A
AU  - Kirkwood AA
AD  - Cancer Research UK & UCL Cancer Trials Centre, UCL Cancer Institute, University 
      College London, London, UK.
FAU - Roddie, C
AU  - Roddie C
AUID- ORCID: 0000-0002-4901-5858
AD  - Department of Haematology, University College London Hospitals, London, UK.
AD  - UCL Cancer Institute, University College London, London, UK.
FAU - Menne, T
AU  - Menne T
AUID- ORCID: 0000-0002-3289-2344
AD  - Department of Haematology, Freeman Hospital, Newcastle, UK.
FAU - Tholouli, E
AU  - Tholouli E
AD  - Department of Haematology, Manchester Royal Infirmary, Manchester, UK.
FAU - Bloor, A
AU  - Bloor A
AUID- ORCID: 0000-0003-4550-220X
AD  - Department of Haematology, The Christie Hospital, Manchester, UK.
FAU - Besley, C
AU  - Besley C
AD  - Department of Haematology, University Hospitals Bristol and Weston, Bristol, UK.
FAU - Chaganti, S
AU  - Chaganti S
AD  - Department of Haematology, Queen Elizabeth Hospital, Birmingham, UK.
FAU - Osborne, W
AU  - Osborne W
AD  - Department of Haematology, Freeman Hospital, Newcastle, UK.
FAU - Norman, J
AU  - Norman J
AD  - Department of Haematology, Manchester Royal Infirmary, Manchester, UK.
FAU - Gibb, A
AU  - Gibb A
AD  - Department of Haematology, The Christie Hospital, Manchester, UK.
FAU - Sharplin, K
AU  - Sharplin K
AD  - Department of Haematology, University Hospitals Bristol and Weston, Bristol, UK.
FAU - Cuadrado, M
AU  - Cuadrado M
AD  - Department of Haematology, King's College Hospital, London, UK.
FAU - Correia de Farias, M
AU  - Correia de Farias M
AD  - Department of Haematology, King's College Hospital, London, UK.
FAU - Cheok, K
AU  - Cheok K
AD  - Department of Haematology, University College London Hospitals, London, UK.
FAU - Neill, L
AU  - Neill L
AD  - Department of Haematology, University College London Hospitals, London, UK.
FAU - Latif, A L
AU  - Latif AL
AD  - Department of Haematology, Queen Elizabeth II Hospital, Glasgow, UK.
FAU - Gonzalez Arias, C
AU  - Gonzalez Arias C
AD  - Department of Haematology, Royal Marsden Hospital, London, UK.
FAU - Uttenthal, B
AU  - Uttenthal B
AD  - Department of Haematology, Addenbrooke's Hospital, Cambridge, UK.
FAU - Jones, C
AU  - Jones C
AD  - Department of Haematology, University Hospital of Wales, Cardiff, UK.
FAU - Johnson, R
AU  - Johnson R
AUID- ORCID: 0000-0002-0441-8688
AD  - Department of Haematology, St. James's Hospital, Leeds, UK.
FAU - McMillan, A
AU  - McMillan A
AD  - Department of Haematology, Nottingham University Hospitals, Nottingham, UK.
FAU - Sanderson, R
AU  - Sanderson R
AUID- ORCID: 0000-0003-4915-2833
AD  - Department of Haematology, King's College Hospital, London, UK.
FAU - Townsend, W
AU  - Townsend W
AD  - Department of Haematology, University College London Hospitals, London, UK.
LA  - eng
PT  - Journal Article
DEP - 20230420
PL  - England
TA  - Br J Haematol
JT  - British journal of haematology
JID - 0372544
RN  - 0 (Receptors, Chimeric Antigen)
RN  - 0 (Adaptor Proteins, Signal Transducing)
RN  - 0 (Antigens, CD19)
SB  - IM
MH  - Humans
MH  - Autografts
MH  - *Receptors, Chimeric Antigen
MH  - Transplantation, Autologous
MH  - *Transplants
MH  - Adaptor Proteins, Signal Transducing
MH  - Antigens, CD19
MH  - Cytokine Release Syndrome
MH  - *Lymphoma, Large B-Cell, Diffuse/therapy
MH  - Immunotherapy, Adoptive/adverse effects
OTO - NOTNLM
OT  - ASCT unfit
OT  - CD19 CAR T
OT  - cellular therapies
OT  - large B-cell lymphoma
EDAT- 2023/04/21 06:41
MHDA- 2023/06/27 06:42
CRDT- 2023/04/21 02:32
PHST- 2023/03/28 00:00 [revised]
PHST- 2023/01/11 00:00 [received]
PHST- 2023/03/31 00:00 [accepted]
PHST- 2023/06/27 06:42 [medline]
PHST- 2023/04/21 06:41 [pubmed]
PHST- 2023/04/21 02:32 [entrez]
AID - 10.1111/bjh.18810 [doi]
PST - ppublish
SO  - Br J Haematol. 2023 Jul;202(1):65-73. doi: 10.1111/bjh.18810. Epub 2023 Apr 20.