System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Ahead of print

PubMed: 42779302 DOI: 10.3324/haematol.2026.300977

Different treatment eras for relapsed and refractory primary mediastinal B-cell lymphoma patients: accessibility to CAR T cells is associated with a better prognosis in a pooled analysis of the REPRIME-FIL and the CART-SIE studies.

Haematologica

Authors: Anna Guidetti, Irene Dogliotti, Annalisa Chiappella, Emilio Iannitto, Andrea Evangelista, Anna Dodero, Alice Di Rocco, Monica Balzarotti, Beatrice Casadei, Federica Cavallo, Alessandro Re, Mirko Farina, Stefania Bramanti, Patrizia Chiusolo, Massimo Martino, Maurizio Musso, Manuela Zanni, Giovanni Grillo, Emanuele Ravano, Mauro Krampera, Stefan Hohaus, Maurizio Martelli, Giulia Zacchi, Carlo Visco, Pier Luigi Zinzani, Ugo Consoli, Paolo Corradini

Affiliations

  • Division of Hematology and Bone Marrow Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy; Department of Pathophysiology and Transplantation, University of Milano.
  • Division of Hematology, University of Torino, A.O.U. "Città della Salute e della Scienza", Torino.
  • Division of Hematology and Bone Marrow Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano.
  • UOC di Oncoematologia e TMO, Dipartimento Oncologico "La Maddalena" Palermo.
  • Unit of Clinical Epidemiology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza e CPO, Piemonte.
  • Department of Precision Medicine, Sapienza University, Roma.
  • Department of Oncology/Hematology, IRCCS Humanitas Research Hospital, Rozzano, Milano.
  • IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna.
  • Division of Hematology, University of Torino, A.O.U. "Città della Salute e della Scienza", Torino, Italy; Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino.
  • Hematology, ASST Spedali Civili di Brescia.
  • Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma.
  • Hematology and Stem Cell Transplantation and Cellular Therapies Unit (CTMO), Department of Hemato-Oncology and Radiotherapy, Grande Ospedale Metropolitano "Bianchi- Melacrino-Morelli", Reggio Calabria.
  • SCDU Ematologia AO SS Antonio e Biagio e Cesare Arrigo ed Università del Piemonte Orientale, Alessandria.
  • Dipartimento di Ematologia e Trapianto di Midollo, ASST Grande Ospedale Metropolitano Niguarda, Milano.
  • Hematology and Bone Marrow Transplant Unit, Section of Biomedicine of Innovation, Department of Engineering for Innovative Medicine (DIMI), University of Verona.
  • IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy; Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna.
  • UOC Ematologia ARNAS Garibaldi, Catania.
  • Division of Hematology and Bone Marrow Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy; Department of Pathophysiology and Transplantation, University of Milano.

Abstract

Chimeric Antigen Receptor (CAR) T-cell therapy targeting CD19 has demonstrated efficacy as salvage treatment for patients with relapsed/refractory (R/R) primary mediastinal B-cell lymphoma (PMBCL), however, a direct comparison between CAR T activity and other salvage treatments has not previously been performed. This study aims to compare overall survival (OS) in R/R PMBCL patients treated in different eras who reflect accessibility to CAR T-cells in R/R patient treated after 2019 and treatment with other salvage programs in the years before. We performed a pooled analysis including all pts affected by R/R PMBCL enrolled in the ongoing multicenter prospective observational study CART-SIE and in the retrospective REPRIME-FIL study. A total of 191 patients were included, 87 receiving CAR T cells and 104 treated with other salvage therapies. The 3-year OS from failure of first line treatment for the entire cohort was 62% (95% CI 55-69). The 6-months landmark analysis showed that patients treated with CAR T cells had a significantly reduced risk of death and a superior OS compared with those receiving other regimens (adjusted HR 0.34; 95%CI 0.17-0.66, p=0.001). Patients treated with CAR T cells also had superior OS compared with the subgroup of REPRIME patients who underwent ASCT (adjusted HR 0.27; 95%CI 0.13-0.66, p=0.001). Within the limitations inherent to a pooled analysis, administration of CAR T cells during salvage of R/R PMBCL patients appears to be associated with a longer OS with a risk of death approximately one-third of that observed in patients managed without CAR T.

MeSH

Cells, Hematology, Lymphoma, B-Cell, Lymphoma, Therapeutics, B-Lymphocytes, Prognosis, Salvage Therapy, Car-T Cell