TRANSCAR：CD19 CAR-T 细胞治疗复发/难治性转化型惰性淋巴瘤的真实世界结局

Anti-CD19 chimeric antigen receptor (CAR) T cells have shown impressive results in the treatment of relapsed/refractory aggressive large B-cell lymphomas (LBCLs).

However, the prognostic value of the LBCL histological subtype in the context of CAR T-cell therapy is unclear.

Here, we report the prognostic value of transformed indolent non-Hodgkin lymphoma (TriNHL; N = 110) confirmed by an expert pathological review (LYMPHOPATH) vs de novo LBCL (N = 391) in the context of CAR T-cell therapy from 4 centers of the French DESCAR-T registry. After 1:1 propensity score matching (n = 170, 85 patients with TriNHL and 85 patients with de novo LBCL), the median follow-up was 19. 4 months (95% confidence interval [CI], 12. 0-25. 1) for patients with TriNHL and 18. 5 months (95% CI, 13. 8-24. 8) for patients with LBCL. The 1-year progression-free survival rate was significantly better (55. 8%; 95% CI, 43. 6-66.

4) in the TriNHL group than in the de novo LBCL group (31. 7%; 95% CI, 21. 4-42. 6; hazard ratio, 0. 54; 95% CI, 0. 36-0. 82; P = . 0034). The best overall response rate and complete response rate were 82. 4% and 63. 5%, respectively, whereas they were 63. 5% and 50. 6%, respectively, for the TriNHL group compared with the de novo LBCL group.

The 1-year overall survival was also longer in the TriNHL group than in the de novo LBCL group (72. 1%, [95% CI, 59. 6-81. 4] vs 50. 7%, [95% CI, 38. 2-62. 0]; P = . 031). Similar findings were found via an inverse probability weighting statistical approach. No difference was observed in terms of toxicity.

In conclusion, our matched-comparison study revealed a greater efficacy of CAR T-cell therapy, with a toxicity profile for patients with TriNHL comparable with that for patients with LBCL.