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CAR-T Therapy for NHL Treats Concurrent Rheumatic Disease

Lucy Hicks

DISCLOSURES

TOPLINE:

Chimeric antigen receptor–T cell (CAR-T) therapy may effectively treat B-cell non-Hodgkin lymphoma (NHL) while also improving control of autoimmune disease in patients with both conditions.

METHODOLOGY:

  • It is unknown whether anti-CD19 CAR-T therapy is safe and effective in patients with concurrent B-cell NHL and rheumatic autoimmune disease.
  • Researchers used the TriNetX database to identify patients with B-cell NHL treated with CD19-targeted CAR-T therapy between January 2019 to January 2023.
  • Time-to-next treatment or death (TNT-D) and survival rates in 58 patients with and 58 matched patients without autoimmune disease was compared.
  • Researchers compared cytokine release syndrome (CRS) in patients who received CAR-T after January 2021 and immune effector cell-associated neurotoxicity syndrome (ICANS) in a smaller cohort who received CAR-T therapy after January 2022.
  • They also evaluated autoimmune disease activity in patients with concurrent NHL and autoimmune disease. 

TAKEAWAY:

  • There was no significant difference in CRS or ICAN between groups with and without autoimmune disease.
  • The groups also had similar TNT-D and overall survival.
  • Patients with autoimmune diseases had lower inflammatory markers, seronegative conversion of autoantibodies, and reduced use of steroids and disease-modifying antirheumatic drugs after CAR-T therapy.

IN PRACTICE:

This study is too preliminary to have practice application.

SOURCE:

Jiasheng Wang, MD, of the University Hospitals Cleveland Medical Center in Ohio led the research. The study was published August 21, 2023, in Bone Marrow Transplantation

LIMITATIONS:

The study was a retrospective analysis of electronic health records, used surrogate markers for response and progression-free survival, measured autoimmune disease response by biochemical markers and not symptoms, and had a relatively small sample size.

DISCLOSURES:

The authors declared no competing interests.

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