Outcomes among adult recipients of CAR T-cell therapy for Burkitt lymphoma
Abstract
Abstract Burkitt lymphoma (BL) is an aggressive B-cell lymphoma that is associated with poor outcomes in patients with relapsed/refractory disease. This multicenter, retrospective study evaluated real-world CD19 chimeric antigen receptor (CAR) T-cell therapy outcomes in patients with relapsed/refractory BL using data abstracted from the medical records. In total, 31 patients received CAR T cells after a median of 3 previous therapies (range, 1-6). Patients received axicabtagene ciloleucel (n = 19), lisocabtagene maraleucel (n = 4), tisagenlecleucel (n = 4), or other agents (n = 4). Grade 1 to 2 cytokine release syndrome occurred in 83.9% of patients (grade ≥3, 65%), and grade 1 to 2 immune effector cell-associated neurotoxicity syndrome (ICANS) occurred in 29% of patients (grade ≥3, 19.4%). The 28-day mortality rate was 16.1%, including 1 patient who died from grade 5 ICANS. The overall response rate at 1 month was 58.0% with a complete response (CR) rate of 41.9%; however, the 6-month CR rate was only 19.4%. The median progression-free survival was 2.3 months (95% confidence interval, 1.0-9.0), and the median overall survival was 6.0 months (95% confidence interval, 1.9-11.5). Three patients (9.7%) received consolidative allogeneic stem cell transplants, but all subsequently relapsed. In conclusion, CD19 CAR T-cell therapy infrequently delivers long-term disease control in BL. Further investigation is needed to determine the most effective alternative management strategy for these patients.
Article Details
Authors (38)
Laura Samples
1Laboratory of Lymphoid Malignancies, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
Hossein Sadrzadeh
3Section of Hematology and Medical Oncology, Boston University Medical Center, Boston, MA
Matthew J. Frigault
3Massachusetts General Hospital, Boston, MA
Caron A. Jacobson
5Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
Mehdi Hamadani
12Blood and Marrow Transplant and Cellular Therapy Program, Medical College of Wisconsin, Milwaukee, WI
Ashwath Gurumurthi
7Department of Lymphoma/Myeloma, The University of Texas MD Anderson Medical Center, Houston, TX
Paolo Strati
Roni Shouval
1Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
Ariela Noy
2Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY
Peter A. Riedell
Saurabh Dahiya
David G. Maloney
Fred Hutchinson Cancer Center, Seattle, Washington, United States
Brian G. Till
Alexandre V. Hirayama
1Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA
Jordan Gauthier
Ajay K. Gopal
Fred Hutchinson Cancer Center and University of Washington
Stephen D. Smith
19Division of Hematology and Oncology, Fred Hutchinson Cancer Center, Seattle, WA
Christina Poh
2City of Hope, Duarte, United States
Ryan Lynch
1Fred Hutchinson Cancer Center, Seattle, United States
Chaitra Ujjani
15Fred Hutchinson Cancer Research Center, Seattle, United States
Mengyang Di
5Fred Hutchinson Cancer Research Center, Seattle, United States
Vikram Raghunathan
1Fred Hutchinson Cancer Center, Seattle, United States
Mehrdad Shakib-Azar
1Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA
Kikkeri N. Naresh
1Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA
Ted A. Gooley
1Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA
Jean Yared
1University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, United States
Michael D. Jain
Frederick L. Locke
Lori Ann Leslie
13Division of Lymphoma, John Theurer Cancer Center, Hackensack, NJ
Narendranath Epperla
University of Utah, Salt Lake City, Utah, United States
Monalisa Ghosh
Alan Skarbnik
19Novant Health Cancer Institute, Department of Hematology, Charlotte, United States
Brian T. Hill
9Cleveland Clinic Foundation, Cleveland, OH
Manali K. Kamdar
18Division of Hematology, University of Colorado Hospital, Aurora, CO
Valentin Ortiz-Maldonado
1Hospital Clínic de Barcelona, Department of Hematology, Barcelona, Spain
Nuria Martínez-Cibrian
Hematology Department. Hospital Clínic, Barcelona, Spain
Leyla Shune
Mazyar Shadman