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Lin H, Deng T, Jiang L, Meng F, Cao Y, Zhang Y, Ge R, Zhu X. Adverse Reactions in Relapsed/Refractory B-Cell Lymphoma Administered with Chimeric Antigen Receptor T Cell Alone or in Combination with Autologous Stem Cell Transplantation. Cancers (Basel) 2024; 16:1722. [PMID: 38730674 PMCID: PMC11083715 DOI: 10.3390/cancers16091722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/21/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
(1) Background: The combination of CAR-T with ASCT has been observed to enhance the efficacy of CAR-T cell therapy. However, the impact of this combination on adverse reactions is still uncertain. (2) Methods: Between January 2019 and February 2023, 292 patients diagnosed with r/r B-cell lymphoma received either CAR-T therapy alone or in combination with ASCT at our institution. We evaluated the incidence of CRS and CRES and utilized a logistic regression model to identify factors contributing to severe CRS (grade 3-4) and CRES (grade 3-4). (3) Results: The overall incidence of CRS and CRES was 78.9% and 8.2% in 147 patients receiving CAR-T alone, and 95.9% and 15.2% in 145 patients receiving CAR-T combined with ASCT, respectively. The incidence of overall CRS (p < 0.0001) and mild CRS (grade 1-2) (p = 0.021) was elevated in the ASCT combined with CAR-T group. No significant difference was observed in severe CRS and CRES between the groups. Among the 26 cases of lymphoma involving the central nervous system (CNS), 96.2% (25/26) developed CRS (15.4% grade 3-4), and 34.6% (9/26) manifested CRES (7.7% grade 3-4). Female patients had a lower incidence of severe CRS but a higher incidence of severe CRES. Lymphomas with CNS involvement demonstrated a higher risk of CRES compared to those without central involvement. (4) Conclusions: The combination of ASCT with CAR-T demonstrated a preferable option in r/r B-cell lymphoma without an increased incidence of severe CRS and CRES.
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Affiliation(s)
- Haolong Lin
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (H.L.); (L.J.); (F.M.); (Y.C.); (Y.Z.)
- Immunotherapy Research Center for Hematologic Diseases of Hubei Province, Wuhan 430030, China
| | - Ting Deng
- Department of Hematology, Chongqing Fifth People’s Hospital, Chongqing 400062, China;
| | - Lijun Jiang
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (H.L.); (L.J.); (F.M.); (Y.C.); (Y.Z.)
- Immunotherapy Research Center for Hematologic Diseases of Hubei Province, Wuhan 430030, China
| | - Fankai Meng
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (H.L.); (L.J.); (F.M.); (Y.C.); (Y.Z.)
- Immunotherapy Research Center for Hematologic Diseases of Hubei Province, Wuhan 430030, China
| | - Yang Cao
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (H.L.); (L.J.); (F.M.); (Y.C.); (Y.Z.)
- Immunotherapy Research Center for Hematologic Diseases of Hubei Province, Wuhan 430030, China
| | - Yicheng Zhang
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (H.L.); (L.J.); (F.M.); (Y.C.); (Y.Z.)
- Immunotherapy Research Center for Hematologic Diseases of Hubei Province, Wuhan 430030, China
| | - Renying Ge
- Department of Hematology, Xianning Central Hospital, The First Affiliated Hospital to Hubei University of Science and Technology, Xianning 437100, China
| | - Xiaojian Zhu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (H.L.); (L.J.); (F.M.); (Y.C.); (Y.Z.)
- Immunotherapy Research Center for Hematologic Diseases of Hubei Province, Wuhan 430030, China
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Tu S, Li P, Mei H, Liu Y, Hu Y, Liu P, Zou D, Niu T, Xu K, Wang L, Yang J, Zhao M, Huang X, Wang J, Hu Y, Zhao W, Wu D, Ma J, Qian W, Han W, Li Y, Liang A. Chinese expert consensus on integrated case management by a multidisciplinary team in CAR-T cell therapy for lymphoma. Chin Med J (Engl) 2024:00029330-990000000-01025. [PMID: 38570196 DOI: 10.1097/cm9.0000000000003085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Indexed: 04/05/2024] Open
Affiliation(s)
- Sanfang Tu
- Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou,Guangdong 510280, China
| | - Ping Li
- Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Heng Mei
- Institute of Hematology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Yang Liu
- Department of Bio-therapeutic, Chinese PLA General Hospital, Beijing 100853, China
| | - Yongxian Hu
- Center for Bone Marrow Transplantation, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Peng Liu
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai 200032,China
| | - Dehui Zou
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Division of Pediatric Blood Disease Center, Institute of Hematology & Blood Disease Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Ting Niu
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Kailin Xu
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, China
| | - Li Wang
- Department of Hematology, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jianmin Yang
- Department of Hematology, Changhai Hospital, The Naval Medical University, Shanghai 210000, China
| | - Mingfeng Zhao
- Department of Hematology, Tianjin First Central Hospital, The First Affiliated Central Hospital of Nankai University, The First Central Clinical College of Tianjin Medical University, Tianjin 300192, China
| | - Xiaojun Huang
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology Beijing Key Laboratory of Haematopoietic Stem Cell Transplantation Research Unit of Key Technique for Diagnosis and Treatments of Haematologic Malignancies, Chinese Academt of Medical Sciences, Peking University, Beijing 100044, China
| | - Jianxiang Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Division of Pediatric Blood Disease Center, Institute of Hematology & Blood Disease Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Yu Hu
- Institute of Hematology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Weili Zhao
- Department of Hematology, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Depei Wu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
| | - Jun Ma
- Harbin Institute of Hematology and Cancer, Harbin, Heilongjiang 150001, China
| | - Wenbin Qian
- Department of Hematology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310009, China
| | - Weidong Han
- Department of Bio-therapeutic, Chinese PLA General Hospital, Beijing 100853, China
| | - Yuhua Li
- Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou,Guangdong 510280, China
| | - Aibin Liang
- Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
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Guo Y, Tong C, Wu Z, Lu Y, Wang Y, Han W. Reciprocal activation of antigen-presenting cells and CAR T cells triggers a widespread endogenous anti-tumor immune response through sustained high-level IFNγ production. Cancer Biol Med 2023; 20:j.issn.2095-3941.2023.0324. [PMID: 37929324 PMCID: PMC10690879 DOI: 10.20892/j.issn.2095-3941.2023.0324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/10/2023] [Indexed: 11/07/2023] Open
Affiliation(s)
- Yelei Guo
- Department of Bio-therapeutic, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Chuan Tong
- Department of Bio-therapeutic, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhiqiang Wu
- Department of Bio-therapeutic, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Yuting Lu
- Department of Bio-therapeutic, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Yao Wang
- Department of Bio-therapeutic, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Weidong Han
- Department of Bio-therapeutic, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
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Lu Y, Liu H, Ye SG, Zhou LL, Luo X, Dang XY, Yuan XG, Qian WB, Liang AB, Li P. [Efficacy and safety analysis of the zanubrutinib-based bridging regimen in chimeric antigen receptor T-cell therapy for relapsed/refractory diffuse large B-cell lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2023; 44:813-819. [PMID: 38049332 PMCID: PMC10694070 DOI: 10.3760/cma.j.issn.0253-2727.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Indexed: 12/06/2023]
Abstract
Objective: To further elucidate the clinical efficacy and safety of a combination regimen based on the BTK inhibitor zebutanil bridging CD19 Chimeric antigen receptor T cells (CAR-T cells) in the treatment of relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL) . Methods: Twenty-one patients with high-risk r/r DLBCL were treated with a zanubrutinib-based regimen bridging CAR-T between June 2020 and June 2023 at the Department of Hematology, Tongji Hospital, Tongji University and the Second Affiliated Hospital of Zhejiang University, and the efficacy and safety were retrospectively analyzed. Results: All 21 patients were enrolled, and the median age was 57 years (range: 38-76). Fourteen patients (66.7%) had an eastern cooperative oncology group performance status score (ECOG score) of ≥2. Eighteen patients (85.7%) had an international prognostic index (IPI) score of ≥3. Three patients (14.3%) had an IPI score of 2 but had extranodal infiltration. Fourteen patients (66.7%) had double-expression of DLBCL and seven (33.3%) had TP53 mutations. With a median follow-up of 24.8 (95% CI 17.0-31.6) months, the objective response rate was 81.0%, and 11 patients (52.4%) achieved complete remission. The median progression-free survival (PFS) was 12.8 months, and the median overall survival (OS) was not reached. The 1-year PFS rate was 52.4% (95% CI 29.8% -74.3%), and the 1-year OS rate was 80.1% (95% CI 58.1% -94.6%). Moreover, 18 patients (85.7%) had grade 1-2 cytokine-release syndrome, and two patients (9.5%) had grade 1 immune effector cell-associated neurotoxicity syndrome. Conclusion: Zanubrutinib-based combination bridging regimen of CAR-T therapy for r/r DLBCL has high efficacy and demonstrated a good safety profile.
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Affiliation(s)
- Y Lu
- Department of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - H Liu
- Department of Hematology, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, China
| | - S G Ye
- Department of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - L L Zhou
- Department of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - X Luo
- Department of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - X Y Dang
- Department of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - X G Yuan
- Department of Hematology, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, China
| | - W B Qian
- Department of Hematology, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, China
| | - A B Liang
- Department of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - P Li
- Department of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
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