Subsequent Malignancies After CD19-Targeted Chimeric Antigen Receptor T Cells in Patients With Lymphoma

Rachel Lorenc, Roni Shouval, Jessica R. Flynn, Sean M. Devlin, Amethyst Saldia, Alejandro Luna De Abia, Magdalena Corona De Lapuerta, Ana Alarcon Tomas, Giulio Cassanello, Lori A. Leslie, Kai Rejeski, Richard J. Lin, Michael Scordo, Gunjan L. Shah, M. Lia Palomba, Gilles Salles, Jae Park, Sergio A. Giralt, Miguel Angel Perales, Andrew IpParastoo B. Dahi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Chimeric antigen receptor (CAR) T cells are an established treatment for B cell non-Hodgkin lymphomas (B-NHL). With the remarkable success in improving survival, understanding the late effects of CAR T cell therapy is becoming more relevant. The aim of this study is to determine the incidence of subsequent malignancies in adult patients with B-NHL. We retrospectively studied 355 patients from 2 different medical centers treated with four different CAR T cell products from 2016 to 2022. The overall cumulative incidence for subsequent malignancies at 36 months was 14% (95% CI: 9.2%, 19%). Subsequent malignancies were grouped into 3 primary categories: solid tumor, hematologic malignancy, and dermatologic malignancy with cumulative incidences at 36 months of 6.1% (95% CI: 3.1%-10%), 4.5% (95% CI: 2.1%-8.1%) and 4.2% (95% CI: 2.1%-7.5%) respectively. Notably, no cases of T cell malignancies were observed. In univariable analysis, increasing age was associated with higher risk for subsequent malignancy. While the overall benefits of CAR T products continue to outweigh their potential risks, more studies and longer follow ups are needed to further demonstrate the risks, patterns, and molecular pathways that lead to the development of subsequent malignancies.

Original languageEnglish
Pages (from-to)990-1000
Number of pages11
JournalTransplantation and Cellular Therapy
Volume30
Issue number10
Early online date6 Jul 2024
DOIs
StatePublished - Oct 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2024 The American Society for Transplantation and Cellular Therapy

Keywords

  • Chimeric antigen receptor (CAR) T-cells
  • Diffuse large B cell lymphoma
  • Follicular lymphoma
  • Myelodysplastic syndrome
  • Non-Hodgkin lymphoma
  • Subsequent malignancy
  • T cell malignancy
  • late effects

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