Outcomes of patients with relapsed or refractory primary mediastinal B‐cell lymphoma treated with anti‐CD19 CAR‐T cells: CARTHYM, a study from the French national DESCAR‐T registry

作者：Jean Galtier, Charles Mesguich, Pierre Sesques, Vivien Dupont, Emmanuel Bachy, Roberta Di Blasi, Catherine Thiéblemont, Thomas Gastinne, Guillaume Cartron, Gabriel Brisou, François‐Xavier Gros, Justine Decroocq, Franck Morschhauser, Marie‐Thérèse Rubio, Laurianne Drieu La Rochelle, Fabien Le Bras, Sylvain Carras, Adrien Chauchet, Jacques‐Olivier Bay, Magalie Joris, Michaël Loschi, Aline Schmidt, Alexandra Marquet, Vincent Camus, Steven Le Gouill, Roch Houot, Krimo Bouabdallah · 发表于：HemaSphere · 年份：2025 · DOI：10.1002/hem3.70091 · 被引用次数：14 · 研究领域：CAR-T cell therapy research、Lymphoma Diagnosis and Treatment、Silicon Carbide Semiconductor Technologies

Primary mediastinal B-cell lymphoma (PMBL) is often cured with dose-dense anthracycline-based regimens but the prognosis at relapse or progression remains poor. While anti-CD19 CAR-T cell therapy has dramatically improved outcomes in relapsed or refractory large B-cell lymphoma, far less is known about their efficacy in PMBL. Using the systematic record of all patients treated with CAR-T cells prospectively included in the DESCAR-T registry in France, along with centrally reviewed positon-emission tomography (PET) imaging, we describe the outcomes and key determinants of treatment success in PMBL patients treated over a 6-year period. Among 82 patients infused in the registry we observed a best complete response (CR) rate, 2-year progression-free survival (PFS), and 2-year overall survival (OS) of 68.1%, 57.4%, and 73.8%, respectively. Outcomes were even better for the 62 patients infused with axicabtagene ciloleucel, with best CR rate, 2-year PFS, and 2-year OS reaching 74.5%, 70.4%, and 86.9%, respectively. Achieving a Deauville score of 1-4 or a ΔSUVmax reduction of more than 24% at the 1-month evaluation was associated with excellent outcomes, whereas increased total metabolic tumor volume baseline PET increased the risk of treatment failure. Surprisingly, neither the response to bridging therapy nor the type of bridging therapy (chemotherapy versus immune checkpoint inhibitors) were associated with long-term outcomes. In conclusion, this study confirms that anti-CD19 CAR...