合并 B 细胞非霍奇金淋巴瘤与风湿性自身免疫性疾病患者的 CD19 靶向 CAR-T 细胞治疗：倾向性评分匹配研究

Rheumatic autoimmune diseases not only involve the production of autoantibodies but also demonstrate T-cell dysfunction. In patients with concurrent B-cell non-Hodgkin lymphoma (NHL) and rheumatic autoimmune diseases, the safety and efficacy of CD19-targeted chimeric antigen receptor (CAR) T-cell therapy are unknown.

Using an aggregated electronic health record database, patients with rheumatic autoimmune diseases (auto group) were compared to propensity score-matched patients without rheumatic autoimmune diseases (non-auto group). From 1/2019 to 1/2023, 58 (4. 3%) of 1,363 patients who received CD19-targeted CAR T-cell therapy had concurrent rheumatic autoimmune diseases. Both groups had similar incidence, severity, and management of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS).

Moreover, the two groups had similar time-to-next treatment or death (hazard ratio [HR] 0. 97, 95% confidence interval [CI] 0. 60 to 1. 59, log-rank p = 0. 91) and overall survival (HR 0. 90, 95%CI 0. 46 to 1. 78, p = 0. 76). Following CAR T-cell infusion, patients with rheumatic autoimmune diseases achieved decreased inflammatory markers, seronegative conversion of autoantibodies, as well as reduced use of steroids and disease-modifying anti-rheumatic drugs.

In conclusion, the safety and efficacy of CAR T-cell therapy were not affected in patients with rheumatic autoimmune diseases.

Moreover, they achieved better biochemical control of underlying rheumatic diseases.