Non-Relapse Mortality after CAR T-Cell therapy for Large B-Cell Lymphoma: A LYSA Study from the DESCAR-T Registry - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Blood Advances Année : 2023

Non-Relapse Mortality after CAR T-Cell therapy for Large B-Cell Lymphoma: A LYSA Study from the DESCAR-T Registry

Emmanuel Bachy
Thomas Gastinne
  • Fonction : Auteur
Roberta Di Blasi
Marie-Thérèse Rubio
  • Fonction : Auteur
Stéphanie Guidez
Olivier Casasnovas
  • Fonction : Auteur
Magalie Joris
  • Fonction : Auteur
Cristina Castilla-Llorente
  • Fonction : Auteur
Corinne Haioun
  • Fonction : Auteur
Michael Loschi
Sylvain Carras
Tom Fradon
  • Fonction : Auteur
Charles Herbaux
Pierre Sesques
Steven Le Gouill
Catherine Thieblemont
  • Fonction : Auteur

Résumé

CD19 chimeric antigen receptor (CAR) T cells can induce prolonged remissions and potentially cure a significant proportion of patients with relapsed/refractory large B-cell lymphomas. However, some patients may die of causes unrelated to lymphoma after CAR T-cell therapy. To date, little is known about the nonrelapse mortality (NRM) after CAR T-cell therapy. Using the French DESCAR-T registry, we analyzed the incidence and causes of NRM and identified risk factors of NRM. We report on 957 patients who received standard-of-care axicabtagene ciloleucel (n = 598) or tisagenlecleucel (n = 359) between July 2018 and April 2022, in 27 French centers. With a median follow-up of 12.4 months, overall NRM occurred in 48 patients (5.0% of all patients): early (before day 28 after infusion) in 9 patients (0.9% of all patients and 19% of overall NRM), and late (on/after day 28 after infusion) in 39 patients (4.1% of all patients and 81% of overall NRM). Causes of overall NRM were distributed as follows: 56% infections (29% with non-COVID-19 and 27% with COVID-19), 10% cytokine release syndromes, 6% stroke, 6% cerebral hemorrhage, 6% second malignancies, 4% immune effector cell associated neurotoxicities, and 10% deaths from other causes. We report risk factors of early NRM and overall NRM. In multivariate analysis, both diabetes and elevated ferritin level at lymphodepletion were associated with an increased risk of overall NRM. Our results may help physicians in patient selection and management in order to reduce the NRM after CAR T-cell therapy.

Domaines

Cancer

Dates et versions

hal-04244499 , version 1 (16-10-2023)

Identifiants

Citer

Jean Lemoine, Emmanuel Bachy, Guillaume Cartron, David Beauvais, Thomas Gastinne, et al.. Non-Relapse Mortality after CAR T-Cell therapy for Large B-Cell Lymphoma: A LYSA Study from the DESCAR-T Registry. Blood Advances, 2023, 7 (21), pp.6589-6598. ⟨10.1182/bloodadvances.2023010624⟩. ⟨hal-04244499⟩
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