Safety of Axicabtagene Ciloleucel for the Treatment of Relapsed or Refractory Large B-Cell Lymphoma
| Autor: | Kiersten Williams, Joseph Maakaron, Julianna Roddy, Jonathan E. Brammer, Basem M. William, Sam Penza, Ayman Saad, Marcin Puto, Samantha Jaglowski, Allison Grana, Sumithira Vasu, Natalia Gut, Kyle Porter |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male 0301 basic medicine Cancer Research medicine.medical_specialty Health Status Immunotherapy Adoptive Young Adult 03 medical and health sciences Antineoplastic Agents Immunological 0302 clinical medicine Refractory Internal medicine medicine Humans B-cell lymphoma Aged Retrospective Studies Biological Products Performance status business.industry Incidence (epidemiology) Anemia Retrospective cohort study Hematology Middle Aged medicine.disease Thrombocytopenia Progression-Free Survival Lymphoma Survival Rate Transplantation Cytokine release syndrome Treatment Outcome 030104 developmental biology Oncology 030220 oncology & carcinogenesis Retreatment Female Lymphoma Large B-Cell Diffuse Neoplasm Recurrence Local Nervous System Diseases Cytokine Release Syndrome business |
| Zdroj: | Clinical Lymphoma Myeloma and Leukemia. 21:238-245 |
| ISSN: | 2152-2650 |
| DOI: | 10.1016/j.clml.2020.10.005 |
| Popis: | Background Diffuse large B-cell lymphoma is the most common type of non-Hodgkin lymphoma. Recent advances in immunotherapy have resulted in the development of chimeric antigen receptor–modified T-cell (CAR-T) therapy, such as axicabtagene ciloleucel (axi-cel). However, axi-cel administration is not without risks of toxicity. Patients and Methods This retrospective study of 37 patients with relapsed or refractory diffuse large B-cell lymphoma evaluated the incidence and severity of common and severe safety events after axi-cel treatment in a real-world setting. Ninety percent of patients had received 3 or more prior lines of therapy (median prior therapies 3, range 2-7) before receiving CAR-T therapy, and 32.4% had relapsed after prior stem-cell transplantation. Results All but one patient experienced cytokine release syndrome (CRS) of any grade (97.3%). Of those 36 patients, 83.3% experienced maximum CRS grade of 1 or 2, occurring after a median of 27 hours and persisting for a median of 6 days. Twenty-seven patients (73.0%) experienced neurotoxicity of any grade. Of those 27 patients, 96.3% experienced maximum neurotoxicity grade of 2 or higher, occurring after a median of 145 hours (6 days) and persisting for a median of 7 days. All 10 patients aged 65 or older had neurotoxicity of grade 2 or higher, compared to 59.3% (11/27) under age 65 (P = .02). Patients with baseline Eastern Cooperative Oncology Group performance status score of 2 were significantly more likely to have shorter time to neurotoxicity compared to patients with performance status of 0 (P = .01). Conclusion With more real-life experience and data, we will be able to define and refine management of toxicities unique to CAR-T therapy. |
| Databáze: | OpenAIRE |
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