Chimeric antigen receptor T-cell immunotherapy after ASCT effective against CNS lymphoma

Sequential treatment with CD22/19 chimeric antigen receptor (CAR) T-cell immunotherapy after autologous stem cell transplantation (ASCT) seems to have long-term efficacy against central nervous system lymphoma (CNSL), a recent study has found.

The single-centre, open-label, single-arm clinical trial included 13 CNSL patients who underwent ASCT, followed by the infusion of two separate CAR T-cell products: CD22 CAR T-cells were introduced usually a day before the CD19 cells, taking into consideration the patients’ tolerance. Efficacy outcomes included overall response and complete remission rates, while safety was assessed according to side effects such as the cytokine-release syndrome (CRS).

Of the enrolled patients, one had achieved complete remission even before enrolment while another had negative magnetic resonance imaging findings, which the researchers attributed to tumour-sensitive chemotherapy. Both patients received the protocol medication and maintained clinical efficacy without remission until the final visit.

Of the remaining 11 patients, nine responded to CD22/19 CAR T-cell therapy following ASCT. Within 3 months, six patients achieved complete remission while three had partial remission. The overall and complete remission rates were 81.81 percent and 54.55 percent, respectively. The median durable time for the responsive patients was 14.03 months. Two patients failed to respond to the treatment.

In terms of safety, 11 patients experienced low-grade CRS, yielding an incidence rate of 84.62 percent. Of these, nine had fever exceeding 38 °C and were deemed to have grade 1 CRS; the other two had grade 2 CRS with fever accompanied by hypotension and hypoxaemia.