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转化淋巴瘤与 DLBCL 患者对 CAR-T 细胞治疗的有利缓解相关

英文原题：Transformed Lymphoma Is Associated with a Favorable Response to CAR-T-Cell Treatment in DLBCL Patients.

查看英文原题

Transformed Lymphoma Is Associated with a Favorable Response to CAR-T-Cell Treatment in DLBCL Patients.

PubMed 2021/12/02（内容时间） Cancers (Basel) Q2 · IF 4.8（JCR 2025）

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技术：CAR-T弥漫大B细胞淋巴瘤淋巴瘤地区：欧洲
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中文摘要

(1) 背景：CAR-T 细胞疗法是复发/难治性弥漫大 B 细胞淋巴瘤（r/r DLBCL）患者的一种新型治疗选择。预测 CAR-T 细胞治疗后良好结局的参数仍在探索中。(2) 方法：我们分析了在单一学术机构连续接受 tisagenlecleucel 或 axicabtagene ciloleucel 治疗的 36 例 r/r DLBCL 患者。

我们假设淋巴瘤亚型（转化型与 de novo DLBCL）具有预后重要性。我们还评估了年龄、既往治疗、桥接治疗、CAR-T 治疗时及 6 个月时的缓解状态、LDH、CRS 或 ICANS 的发生情况以及 CAR-T-DNA ddPCR 动力学对其预后的影响。(3) 结果：24 例（67%）患者观察到 CRS，14 例（39%）患者观察到 ICANS。20 例（56%）患者达到 CR。CAR-T 后 6 个月内达到 CR 与更好的 PFS（p < 0.0001）和 OS（p < 0.0001）相关。

值得注意的是，转化型（=继发性）淋巴瘤在 PFS（p = 0.0093）和 OS（p = 0.0209）方面均与优于 de novo 疾病的结局相关，且 CR 率为 78% 对 33%（p = 0.0176）。转化型 DLBCL 患者的死亡率为 23%，而 de novo 患者为 56%（p = 0.0209）。(4) 结论：转化型 DLBCL 的存在似乎与 CAR-T 治疗后比 de novo DLBCL 患者更有利的病程相关。

展开英文摘要原文

(1) Background: CAR-T-cell therapy is a novel therapeutic option for patients with relapsed/refractory diffuse large B-cell lymphoma ( r / r DLBCL). The parameters that predict a favorable outcome after CAR-T-cell treatment are a matter of ongoing exploration. (2) Methods: We analyzed 36 consecutive patients with r / r DLBCL receiving tisagenlecleucel or axicabtagene ciloleucel at a single academic institution.

We hypothesized that lymphoma subtypes (transformed versus de novo DLBCL) are of prognostic importance.

We also assessed age, previous treatment, bridging therapy, remission status at the time of CAR-T treatment and at six months, LDH, the occurrence of CRS or ICANS, and CAR-T-DNA ddPCR kinetics for their prognostic impact. (3) Results: CRS was observed in 24 (67%) patients, and ICANS was observed in 14 (39%) patients. CR was achieved in 20 (56%) patients. Achievement of CR within six months after CAR-T was associated with better PFS ( p < 0. 0001) and OS ( p < 0. 0001).

Remarkably, transformed (=secondary) lymphoma was associated with a better outcome than de novo disease for PFS ( p = 0. 0093) and OS ( p = 0. 0209), and the CR rate was 78% versus 33% ( p = 0. 0176). Mortality in patients with transformed DLBCL was 23% compared with 56% in de novo patients ( p = 0. 0209). (4) Conclusion: The presence of transformed DLBCL seems to be associated with a more favorable course after CAR-T treatment than that observed in the de novo DLBCL patients.

论文信息

作者
Nydegger A、Novak U、Kronig MN、Legros M、Zeerleder S、Banz Y、Bacher U、Pabst T
单位
Department of Medical Oncology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland.Switzerland
期刊
Cancers2021 Dec 2
原文标识
PubMed 34885182　·　DOI 10.3390/cancers13236073

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