Ten-year outcomes after tisagenlecleucel T-cell therapy for relapsed or refractory B-cell lymphomas

Anti-CD19 CAR T-cell therapy is a standard treatment for relapsed or refractory (R/R) B-cell non-Hodgkin lymphomas (NHL). Long-term results are uncertain, Researchers at the University of Pennsylvania (Philadelphia) evaluated ten-year outcomes with tisagenlecleucel for R/R B-cell NHL (24 patients with large B-cell lymphoma and 14 with follicular lymphoma). At a median follow-up of 10.1 years (range 7.9-11.5), no relapses had occurred beyond 5.4 years. The 10-year lymphoma-free survival rate was 32% (95% CI 14-51) among patients with large C-cell lymphoma and 47% (20-71) among those with follicular lymphoma. In an analysis that included deaths from any cause, the 10-year progression-free survival rate was 17% (95% CI 5-34) among patients with large B-cell lymphoma and 29% (9-52) among patients with follicular lymphoma; the 10-year overall survival rate was 17% (5-34) and 50% (23-72), respectively. Persistent grade 2 or 3 neutropenia occurred in 2 patients (5%); no late anemia or thrombocytopenia was observed. A second primary cancer developed in 9 patients (10-year cumulative incidence 21%). The 10-year nonrelapse mortality was 18% (14% when deaths related to COVID-19 were excluded). B-cell aplasia persisted in 44% of patients with a long-term response. The authors conclude that among patients with heavily pretreated B-cell NHL, a single infusion of tisagenlecleucel led to decade-long remission in approximately one third of patients with large B-cell lymphoma and in nearly one half of those with follicular lymphoma.