Lemoine J, Bachy E, Cartron G, et al. Non-Relapse Mortality After CAR T-Cell Therapy for Large B-Cell Lymphoma: A LYSA Study from the DESCAR-T Registry. Blood Advances. 2023; (doi: 10.1182/bloodadvances.2023010624).
New findings regarding the incidence and causes of non-relapse mortality (NRM) in patients with relapsed/refractory large B-cell lymphomas (LBCL) may help reduce NRM following CD19 chimeric antigen receptor (CAR) T-cell therapy. The study, which used the French DESCAR-T registry, evaluated NRM in 957 patients with LBCL after CAR T-cell therapy, with 598 assigned to axicabtagene ciloleucel and 359 assigned to tisagenlecleucel. The overall NRM rate after CAR T-cell therapy was 5.0% over a median follow-up of 12.4 months. Of those 48 patients, NRM occurred early (<day 28 post-infusion) in 9 patients and late (≥day 28 post-infusion) in 39 patients. The majority of overall NRM cases — 56% — were caused by infections (29% non-COVID infections and 27% COVID infections), followed by cytokine release syndromes at 10%; strokes, 6%; cerebral hemorrhages, 6%; second malignancies, 6%; immune effector cell-associated neurotoxicity, 4%; and deaths from other causes, 10%. Diabetes and elevated ferritin at lymphodepletion were contributing factors to higher risk of overall NRM in multivariate analysis.