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- Title
Efficacy and safety of CD19-specific CAR-T cell-based therapy in secondary central nervous system lymphoma.
- Authors
Huanxin Zhang; Zhiling Yan; Ying Wang; Yuekun Qi; Yongxian Hu; Ping Li; Jiang Cao; Meng Zhang; Xia Xiao; Ming Shi; Jieyun Xia; Sha Ma; Jianlin Qiao; Hujun Li; Bin Pan; Kunming Qi; Hai Cheng; Haiying Sun; Feng Zhu; Wei Sang
- Abstract
Encouraging response has been achieved in relapsed/refractory (R/R) B-cell lymphoma treated by chimeric antigen receptor T (CAR-T) cells. The efficacy and safety of CAR-T cells in central nervous system lymphoma (CNSL) are still elusive. Here, we retrospectively analyzed 15 patients with R/R secondary CNSL receiving CD19-specific CAR-T cell-based therapy. The patients were infused with CD19, CD19/CD20 or CD19/CD22 CAR-T cells following a conditioning regimen of cyclophosphamide and fludarabine. The overall response rate was 73.3% (11/15), including 9 (60%) with complete remission (CR) and 2 (13.3%) with partial remission (PR). During a median follow-up of 12 months, the median progression-free survival (PFS) was 4 months, and the median overall survival (OS) was 9 months. Of 12 patients with systemic tumor infiltration, 7 (58.3%) achieved CR in CNS, and 5 (41.7%) achieved CR both systemically and in CNS. Median DOR for CNS and systemic disease were 8 and 4 months, respectively. At the end point of observation, of the 7 patients achieved CNS disease CR, one was still alive with sustained CR of CNS disease and systemic disease. The other 6 died of systemic progression. Of the 15 patients, 11 (73.3%) experienced grades 1-2 CRS, and no patient had grades 3-4 CRS. Immune effector cell-associated neurotoxicity syndrome (ICANS) occurred in 3 (20%) patients, including 1 (6.6%) with grade 4 ICANS. All the CRS or ICANS were manageable. The CD19-specific CAR-T cell-based therapy appeared to be a promising therapeutic approach in secondary CNSL, based on its antitumor effects and an acceptable side effect profile, meanwhile more strategies are needed to maintain the response.
- Subjects
CENTRAL nervous system; CHIMERIC antigen receptors; LYMPHOMAS; ERDHEIM-Chester disease
- Publication
Frontiers in Immunology, 2022, Vol 13, p01
- ISSN
1664-3224
- Publication type
Article
- DOI
10.3389/fimmu.2022.965224