Outcomes among adult recipients of CAR T-cell therapy for Burkitt lymphoma.

Abstract: Burkitt lymphoma (BL) is an aggressive B-cell lymphoma that is associated with poor outcomes in patients with relapsed/refractory disease. This multicenter, retrospective study evaluated real-world CD19 chimeric antigen receptor (CAR) T-cell therapy outcomes in patients with relapsed/refractory BL using data abstracted from the medical records. In total, 31 patients received CAR T cells after a median of 3 previous therapies (range, 1-6). Patients received axicabtagene ciloleucel (n = 19), lisocabtagene maraleucel (n = 4), tisagenlecleucel (n = 4), or other agents (n = 4). Grade 1 to 2 cytokine release syndrome occurred in 83.9% of patients (grade ≥3, 65%), and grade 1 to 2 immune effector cell-associated neurotoxicity syndrome (ICANS) occurred in 29% of patients (grade ≥3, 19.4%). The 28-day mortality rate was 16.1%, including 1 patient who died from grade 5 ICANS. The overall response rate at 1 month was 58.0% with a complete response (CR) rate of 41.9%; however, the 6-month CR rate was only 19.4%. The median progression-free survival was 2.3 months (95% confidence interval, 1.0-9.0), and the median overall survival was 6.0 months (95% confidence interval, 1.9-11.5). Three patients (9.7%) received consolidative allogeneic stem cell transplants, but all subsequently relapsed. In conclusion, CD19 CAR T-cell therapy infrequently delivers long-term disease control in BL. Further investigation is needed to determine the most effective alternative management strategy for these patients.