CAR-T 细胞治疗在 70 岁及以上弥漫大 B 细胞淋巴瘤患者中与较年轻患者相比显示相似疗效和毒性：一项多中心队列研究

CD19-directed chimeric antigen receptor (CAR)-T cell therapy has become a standard treatment for relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL). While the benefits of CAR-T cell treatment are clear in the general patient population, there remains a relative scarcity of real-world evidence regarding its efficacy and toxicity in patients (pts) aged 70 years with DLBCL.

We conducted a multicenter retrospective analysis including 172 r/r DLBCL pts with CAR-T cell treatment, axicabtagene ciloleucel or tisagenlecleucel, between 2019 and 2023 at three tertiary centers. Pts were grouped by age at CAR-T infusion (<70 vs. 70 years). Subsequently, descriptive and survival analyses, including propensity score matching, were performed to compare outcomes between both age groups.

We identified 109 pts aged <70 and 63 pts aged 70 years. Overall response rates for both age groups were comparable (77. 7% vs. 78. 3%; p = 0. 63). With a median follow-up of 8. 3 months, median progression-free survival was 10. 2 months (95% confidence interval [CI]: 6. 5-21. 8) and 11. 1 months (95% CI: 4. 9-NR) ( p = 0. 93) for both cohorts.

Median overall survival reached 21. 8 months (95% CI: 11. 8-NR) and 34. 4 months (95% CI: 10. 1-NR) ( p = 0. 97), respectively. No significant differences in the incidence of cytokine release syndrome ( p = 0. 53) or grade 3 neurotoxicity ( p = 0. 56) were observed. Relapse and nonrelapse mortality were not significantly different between both groups.

Our findings provide additional support that CAR-T cell therapy is feasible and effective in patients with r/r DLBCL aged 70 years or older, demonstrating outcomes comparable to those observed in younger patients. CAR-T cell therapy should be not withheld for elderly patients with r/r DLBCL.