Journal Article

Axicabtagene ciloleucel CD19 CAR-T cell therapy results in high rates of systemic and neurologic remissions in ten patients with refractory large B cell lymphoma including two with HIV and viral hepatitis

Fehn, Karen, Mustafa, Jennat, Lombardo, Amanda, Uehlinger, Joan, Wang, Yanhua, Shah, Nishi, de Castro, Alyssa, Gritsman, Kira, Abbasi, Ahmed, Abreu, Michelly, Elkind, Richard, Kornblum, Noah, Derman, Olga, Mantzaris, Ioannis, Peeke, Stephen, Khatun, Fariha, Goldfinger, Mendel, Bachier-Rodriguez, Lizamarie, Shastri, Aditi, Sica, R. Alejandro, Verma, Amit, Janakiram, Murali, Nelson, Randin, Braunschweig, Ira

2020

Overview

Axicabtagene ciloleucel (Axi-cel) is a CD-19 Chimeric Antigen Receptor T cell therapy approved for the treatment of relapsed/refractory diffuse large B cell lymphoma. We treated ten patients with DLBCL post-FDA approval in an inner-city tertiary center in the Bronx. Eight patients (80%) had received ≥ 3 lines of therapy, six patients had received prior radiation, and seven had recurrent disease after prior autologous hematopoietic stem cell transplant (AHCT). Our cohort included one patient with HIV, two patients with hepatitis B, and two patients with CNS involvement of lymphoma. Axi-cel treatment led to significant responses with 8/10 patients achieving a complete remission at 3 months, including both patients with prior CNS involvement. The treatment was generally well tolerated with 20% of patients experiencing grade ≥ 2 CRS. One patient each with HIV and hepatitis B responded without significant toxicities. In conclusion, Axi-cel led to significant efficacy with manageable toxicity in DLBCL in a real-world setting.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Aged / Antigens, CD19 - therapeutic use / Autografts / Axi-cel / B-cell lymphoma / Cancer Research / CD19 antigen / CD19 CAR-T / Cell therapy / Chimeric antigen receptors / CNS and CD-19 CAR-T / Drug therapy / Female / Hematology / Hematopoietic Stem Cell Transplantation / Hematopoietic stem cells / Hepatitis / Hepatitis B / Hepatitis B and CD-19 CAR-T / Hepatitis, Viral, Human - complications / HIV / HIV (Viruses) / HIV and CD-19 CAR-T / HIV Infections - complications / Human immunodeficiency virus / Humans / Immunotherapy, Adoptive / Letter to the Editor / Lymphocytes T / Lymphoma / Lymphoma, Large B-Cell, Diffuse - complications / Lymphoma, Large B-Cell, Diffuse - therapy / Male / Medicine / Medicine & Public Health / Middle Aged / Non-Hodgkin's lymphomas / Oncology / Receptors, Chimeric Antigen - therapeutic use / Remission / Stem cell transplantation / Stem cells / T cells / Toxicity / Transplantation