Safety and efficacy of implanted port use for CAR T-cells infusion in large B-cell lymphoma

作者：Zachary Hunzeker, Anath C. Lionel, Xiaowen Sun, Lei Feng, Sairah Ahmed, Amy Ayers, Michelly Abreu, Jaimole Varghese, Karla Ow, Amelita B. Marzan, Taylor Cain, Minifrida Santiago, Sreekala Nair, Jeremy Ramdial, Elizabeth J. Shpall, Sattva S. Neelapu, Paolo Strati · 发表于：Blood · 年份：2025 · DOI：10.1182/blood-2025-2713 · 研究领域：CAR-T cell therapy research、Cutaneous lymphoproliferative disorders research、Safe Handling of Antineoplastic Drugs

Abstract Background: Peripherally inserted central catheter (PICC) is the most commonly utilized central venous access for chimeric antigen receptor T-cell therapy (CART) infusion, due to hypothetical concern that the angled needle of a Port may enact shear stress on CAR T-cells. However, it has never been demonstrated whether there exists a difference in safety and/or efficacy outcomes among CART recipients depending on method of central venous access. Methods: This is a single-center retrospective study including adult large B-cell lymphoma patients who received standard of care anti-CD19 autologous CART between January 2018 and March 2025. Baseline characteristics were collected before initiation of lymphodepleting chemotherapy. Cytokine release syndrome (CRS) and immune effector cell associated syndrome (ICANS) were prospectively graded according to ASTCT criteria. Response was assessed by Lugano 2014 Criteria. CAR T-cell levels in peripheral blood were measured on day +7 after infusion using a flow cytometry assay based on antibody targeting FMC63 domain of anti-CD19 CAR T cells, as these levels have been reported to be associated with response to CAR T therapy (Blumenberg et al. Blood Adv 2023). Results: Five-hundred and four patients were included in the analysis: 202 (40.0%) received CART via Port, 302 (60.0%) via PICC line or central venous catheter (CVC). No differences in baseline characteristics were observed between the 2 groups (including age, sex, histology, Ea...