抗cd19 CAR-T细胞治疗复发或难治性原发性纵隔b细胞淋巴瘤患者的预后:CARTHYM,来自法国国家DESCAR-T登记处的一项研究

IF 14.6 2区 医学 Q1 HEMATOLOGY
HemaSphere Pub Date : 2025-02-18 DOI:10.1002/hem3.70091
Jean Galtier, Charles Mesguich, Pierre Sesques, Vivien Dupont, Emmanuel Bachy, Roberta Di Blasi, Catherine Thieblemont, Thomas Gastinne, Guillaume Cartron, Gabriel Brisou, François-Xavier Gros, Justine Decroocq, Franck Morschhauser, Marie-Thérèse Rubio, Laurianne Drieu La Rochelle, Fabien Le Bras, Sylvain Carras, Adrien Chauchet, Jacques-Olivier Bay, Magalie Joris, Mickael Loschi, Aline Tanguy-Schmidt, Alexandra Marquet, Vincent Camus, Steven Le Gouill, Roch Houot, Krimo Bouabdallah
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引用次数: 0

摘要

原发性纵隔b细胞淋巴瘤(PMBL)通常用剂量密集的蒽环类药物治疗,但复发或进展的预后仍然很差。虽然抗cd19 CAR-T细胞疗法显著改善了复发或难治性大b细胞淋巴瘤的预后,但对其在PMBL中的疗效知之甚少。利用法国DESCAR-T登记中所有接受CAR-T细胞治疗的患者的系统记录,以及集中审查的位置发射断层扫描(PET)成像,我们描述了6年治疗期间PMBL患者治疗成功的结果和关键决定因素。在登记的82例患者中,我们观察到最佳完全缓解率(CR), 2年无进展生存率(PFS)和2年总生存率(OS)分别为68.1%,57.4%和73.8%。62例患者输注阿昔卡布吉吉洛尔的结果甚至更好,最佳CR率、2年PFS和2年OS分别达到74.5%、70.4%和86.9%。在1个月的评估中,达到1-4的多维尔评分或ΔSUVmax减少超过24%与良好的结果相关,而增加的总代谢肿瘤体积基线PET增加了治疗失败的风险。令人惊讶的是,无论是对桥接治疗的反应还是桥接治疗的类型(化疗还是免疫检查点抑制剂)都与长期预后无关。总之,本研究证实,抗cd19 CAR-T细胞是治疗复发和难治性PMBL的有效标准疗法,并强调了治疗成功的关键决定因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Outcomes of patients with relapsed or refractory primary mediastinal B-cell lymphoma treated with anti-CD19 CAR-T cells: CARTHYM, a study from the French national DESCAR-T registry

Outcomes of patients with relapsed or refractory primary mediastinal B-cell lymphoma treated with anti-CD19 CAR-T cells: CARTHYM, a study from the French national DESCAR-T registry

Primary mediastinal B-cell lymphoma (PMBL) is often cured with dose-dense anthracycline-based regimens but the prognosis at relapse or progression remains poor. While anti-CD19 CAR-T cell therapy has dramatically improved outcomes in relapsed or refractory large B-cell lymphoma, far less is known about their efficacy in PMBL. Using the systematic record of all patients treated with CAR-T cells prospectively included in the DESCAR-T registry in France, along with centrally reviewed positon-emission tomography (PET) imaging, we describe the outcomes and key determinants of treatment success in PMBL patients treated over a 6-year period. Among 82 patients infused in the registry we observed a best complete response (CR) rate, 2-year progression-free survival (PFS), and 2-year overall survival (OS) of 68.1%, 57.4%, and 73.8%, respectively. Outcomes were even better for the 62 patients infused with axicabtagene ciloleucel, with best CR rate, 2-year PFS, and 2-year OS reaching 74.5%, 70.4%, and 86.9%, respectively. Achieving a Deauville score of 1–4 or a ΔSUVmax reduction of more than 24% at the 1-month evaluation was associated with excellent outcomes, whereas increased total metabolic tumor volume baseline PET increased the risk of treatment failure. Surprisingly, neither the response to bridging therapy nor the type of bridging therapy (chemotherapy versus immune checkpoint inhibitors) were associated with long-term outcomes. In conclusion, this study confirms that anti-CD19 CAR-T cells as a valid standard-of-care for relapsed and refractory PMBL and highlights key determinants of treatment success.

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来源期刊
HemaSphere
HemaSphere Medicine-Hematology
CiteScore
6.10
自引率
4.50%
发文量
2776
审稿时长
7 weeks
期刊介绍: HemaSphere, as a publication, is dedicated to disseminating the outcomes of profoundly pertinent basic, translational, and clinical research endeavors within the field of hematology. The journal actively seeks robust studies that unveil novel discoveries with significant ramifications for hematology. In addition to original research, HemaSphere features review articles and guideline articles that furnish lucid synopses and discussions of emerging developments, along with recommendations for patient care. Positioned as the foremost resource in hematology, HemaSphere augments its offerings with specialized sections like HemaTopics and HemaPolicy. These segments engender insightful dialogues covering a spectrum of hematology-related topics, including digestible summaries of pivotal articles, updates on new therapies, deliberations on European policy matters, and other noteworthy news items within the field. Steering the course of HemaSphere are Editor in Chief Jan Cools and Deputy Editor in Chief Claire Harrison, alongside the guidance of an esteemed Editorial Board comprising international luminaries in both research and clinical realms, each representing diverse areas of hematologic expertise.
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