Evaluation of the safety and efficacy of humanized anti-CD19 chimeric antigen receptor T-cell therapy in older patients with relapsed/refractory diffuse large B-cell lymphoma based on the comprehensive geriatric assessment system

Leuk Lymphoma. 2022 Feb;63(2):353-361. doi: 10.1080/10428194.2021.1986216. Epub 2021 Sep 29.

Abstract

Anti-CD19 chimeric antigen receptor (CAR) T-cell therapy has led to unprecedented results to date in relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL), yet its clinical application in elderly patients with R/R DLBCL remains somewhat limited. In this study, a total of 31 R/R DLBCL patients older than 65 years of age were enrolled and received humanized anti-CD19 CAR T-cell therapy. Patients were stratified into a fit, unfit, or frail group according to the comprehensive geriatric assessment (CGA). The fit group had a higher objective response (OR) rate (ORR) and complete response (CR) rate than that of the unfit/frail group, but there was no difference in the part response (PR) rate between the groups. The unfit/frail group was more likely to experience AEs than the fit group. The peak proportion of anti-CD19 CAR T-cells in the fit group was significantly higher than that of the unfit/frail group. The CGA can be used to effectively predict the treatment response, adverse events, and long-term survival.

Keywords: Humanized anti-CD19 CART; R/R DLBCL; comprehensive geriatric assessment; older patients; safety evaluation.

MeSH terms

  • Aged
  • Antigens, CD19
  • Cell- and Tissue-Based Therapy
  • Geriatric Assessment
  • Humans
  • Immunotherapy, Adoptive / adverse effects
  • Immunotherapy, Adoptive / methods
  • Lymphoma, Large B-Cell, Diffuse*
  • Receptors, Chimeric Antigen*

Substances

  • Antigens, CD19
  • Receptors, Chimeric Antigen

Associated data

  • ChiCTR/1800018059