Anti-CD19 chimeric antigen receptor T-cell therapy has less efficacy in Richter transformation than in de novo large B-cell lymphoma and transformed low-grade B-cell lymphoma.

Autor:	Benjamini O; Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Hashomer, Israel; School of Medicine, Faculty of Medical and health Sciences, Aviv University, Tel-Aviv. ohad.benjamini@sheba.health.gov.il., Fried S; Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Hashomer, Israel; School of Medicine, Faculty of Medical and health Sciences, Aviv University, Tel-Aviv., Shouval R; Department of Medicine, Adult Bone Marrow Transplant Service, Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine Weill Cornell Medical College, New York., Flynn JR; Department of Biostatistics and Epidemiology, Memorial Sloan Kettering Cancer Center, New York., Beyar-Katz O; Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa., Leslie LA; John Theurer Cancer Center, Hackensack, University Medical Center, Hackensack New Jersey., Zucherman T; Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa., Yerushalmi R; Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Hashomer, Israel; School of Medicine, Faculty of Medical and health Sciences, Aviv University, Tel-Aviv., Shem-Tov N; Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Hashomer, Israel; School of Medicine, Faculty of Medical and health Sciences, Aviv University, Tel-Aviv., Palomba ML; Department of Medicine, Adult Bone Marrow Transplant Service, Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine Weill Cornell Medical College, New York., Danylesko I; Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Hashomer, Israel; School of Medicine, Faculty of Medical and health Sciences, Aviv University, Tel-Aviv., Sdayoor I; Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Hashomer, Israel; School of Medicine, Faculty of Medical and health Sciences, Aviv University, Tel-Aviv., Malka H; Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa., Itzhaki O; Ella Lemelbaum Institute for Immuno Oncology, Chaim Sheba Medical Center, Hashomer., Suh H; John Theurer Cancer Center, Hackensack, University Medical Center, Hackensack New Jersey., Devlin SM; Department of Biostatistics and Epidemiology, Memorial Sloan Kettering Cancer Center, New York., Marcus R; Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Hashomer, Israel; School of Medicine, Faculty of Medical and health Sciences, Aviv University, Tel-Aviv., Dahi PB; Department of Medicine, Adult Bone Marrow Transplant Service, Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine Weill Cornell Medical College, New York., Jacoby E; School of Medicine, Faculty of Medical and health Sciences, Aviv University, Tel-Aviv, Israel; Department of Pediatric Hematology-Oncology, Safra Children's Hospital, Chaim Sheba Medical Center, Hashomer., Shah GL; Department of Medicine, Adult Bone Marrow Transplant Service, Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York., Sauter CS; Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH., Ip A; John Theurer Cancer Center, Hackensack, University Medical Center, Hackensack New Jersey, United States; Hackensack Meridian School of Medicine, Nutley, NJ., Perales MA; Department of Medicine, Adult Bone Marrow Transplant Service, Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine Weill Cornell Medical College, New York., Nagler A; Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Hashomer, Israel; School of Medicine, Faculty of Medical and health Sciences, Aviv University, Tel-Aviv., Shimoni A; Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Hashomer, Israel; School of Medicine, Faculty of Medical and health Sciences, Aviv University, Tel-Aviv., Scordo M; Department of Medicine, Adult Bone Marrow Transplant Service, Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine Weill Cornell Medical College, New York., Avigdor A; Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Hashomer, Israel; School of Medicine, Faculty of Medical and health Sciences, Aviv University, Tel-Aviv.
Jazyk:	angličtina
Zdroj:	Haematologica [Haematologica] 2024 Nov 01; Vol. 109 (11), pp. 3566-3577. Date of Electronic Publication: 2024 Nov 01.
DOI:	10.3324/haematol.2023.284664
Abstrakt:	The activity of anti-CD19 chimerci antigen receptor (CAR) T-cell therapy in chronic lymphocytic leukemia (CLL) with Richter's transformation (RT) to aggressive large B-cell lymphoma (LBCL) is largely unknown. In a multicenter retrospective study, we report the safety and efficacy of CAR T-cell therapy in patients with RT (N=30) compared to patients with aggressive B-cell lymphoma (N=283) and patients with transformed indolent non-Hodgkin lymphoma (iNHL) (N=141) between April 2016 and January 2023. Two-thirds of patients received prior therapy for CLL before RT and 89% of them received B-cell receptor and B-cell lymphoma 2 inhibitors. Toxicities of CAR T-cell therapy in RT were similar to other lymphomas, with no fatalities related to cytokine release syndrome or immune effector-cell associated neurotoxicity synderome. The 100-day overall response rate and complete response rates in patients with RT were 57% and 47%, respectively. With a median follow-up of 19 months, the median overall survival (OS) was 9.9 months in patients with RT compared to 18 months in de novo LBCL and not reached in patients with transformed iNHL. The OS at 12 months was 45% in patients with RT compared with 62% and 75% in patients with de novo LBCL and transformed iNHL, respectively. In a multivariate analysis, worse OS was associated with RT histology, elevated lactate dehydrogenase, and more prior lines of therapy. CAR T-cell therapy can salvage a proportion of patients with CLL and RT exposed to prior targeted agents; however, efficacy in RT is inferior compared to de novo LBCL and transformed iNHL.
Databáze:	MEDLINE
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