Outcomes among adult recipients of CAR T-cell therapy for Burkitt lymphoma
Laura Samples, Hossein Sadrzadeh, Matthew J. Frigault, Caron A. Jacobson, Mehdi Hamadani, Ashwath Gurumurthi, Paolo Strati, Roni Shouval, Ariela Noy, Peter A. Riedell, Saurabh Dahiya, David G. Maloney, Brian G. Till, Alexandre V. Hirayama, Jordan Gauthier, Ajay K. Gopal, Stephen D. Smith, Christina Poh, Ryan C. Lynch, Chaitra S. Ujjani, Mengyang Di, Vikram Raghunathan, Mehrdad Shakib-Azar, Kikkeri N. Naresh, Ted Gooley, Jean A. Yared, Michael D. Jain, Frederick L. Locke, Lori A. Leslie, Narendranath Epperla, Monalisa Ghosh, Alan P Skarbnik, Brian T. Hill, Manali Kamdar, Valentín Ortiz‐Maldonado, Núria Martínez‐Cibrián, Leyla Shune, Mazyar Shadman
Abstract
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.