Graft-versus-host disease after anti-CD19 chimeric antigen receptor T-cell therapy following allogeneic hematopoietic cell transplantation: a transplant complications and paediatric diseases working parties joint EBMT study

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Guillermo Ortí - , Vall d'Hebron Institute of Oncology (VHIO) (Author)
  • Christophe Peczynski - , Sorbonne Université (Author)
  • William Boreland - , Sorbonne Université (Author)
  • Maeve O’Reilly - , University College London Hospitals NHS Foundation Trust (Author)
  • Malte von Bonin - , Department of Internal Medicine I, University Hospital Carl Gustav Carus Dresden (Author)
  • Adriana Balduzzi - , Fondazione IRCCS San Gerardo dei Tintori, University of Milan - Bicocca (Author)
  • Caroline Besley - , University Hospitals Bristol and Weston NHS Foundation Trust (Author)
  • Krzysztof Kalwak - , Wrocław Medical University (Author)
  • Samppa Ryhänen - , University of Helsinki (Author)
  • Tayfun Güngör - , University of Zurich (Author)
  • Robert F. Wynn - , Manchester University NHS Foundation Trust (Author)
  • Peter Bader - , University Hospital Frankfurt (Author)
  • Stephan Mielke - , Karolinska Institutet (Author)
  • Didier Blaise - , Institut Paoli Calmettes (Author)
  • Persis Amrolia - , Great Ormond Street Hospital for Children NHS Trust (Author)
  • Ibrahim Yakoub-Agha - , University Hospital of Lille (Author)
  • Friso Calkoen - , Utrecht University (Author)
  • Maria Luisa Schubert - , Heidelberg University  (Author)
  • Victoria Potter - , King's College London (KCL) (Author)
  • Herbert Pichler - , Medical University of Vienna (Author)
  • Nicolaus Kröger - , University of Hamburg (Author)
  • Mi Kwon - , Hospital General Universitario Gregorio Marañon (Author)
  • Henrik Sengeloev - , Righospitalet (Author)
  • Anna Torrent - , Catalonian Government (Author)
  • Yves Chalandon - , Geneva University Hospitals (Author)
  • Gwendolyn van Gorkom - , Maastricht University Medical Centre (UMC+) (Author)
  • Christian Koenecke - , Hannover Medical School (MHH) (Author)
  • Charlotte Graham - , King's College London (KCL) (Author)
  • Helene Schoemans - , KU Leuven (Author)
  • Ivan Moiseev - , Pavlov First State Medical University of St. Petersburg (Author)
  • Olaf Penack - , Charité – Universitätsmedizin Berlin, Berlin Institute of Health at Charité (Author)
  • Zinaida Peric - , University of Zagreb (Author)

Abstract

In patients diagnosed with B-acute lymphoblastic leukemia (B-ALL) or B-non-Hodgkin’s lymphoma (B-NHL) relapsing after allogeneic stem cell transplantation (allo-HCT), it is a standard practice to perform anti-CD19 chimeric antigen receptor (CAR) T-cell therapy. When collected from the patient after allo-HCT, the produced CAR-T cells are likely to be donor T-cell-derived, creating unknown safety risks due to their potential allo-reactivity. We therefore performed an EBMT registry-based study on the incidence of graft-versus-host disease (GvHD) in this setting. We included 257 allo-HCT patients (n = 172 ≥ 18 years) with B-ALL or B-NHL, treated with anti-CD19 CAR T-cells (tisagenlecleucel n = 184, brexucabtagene autoleucel n = 43 and axicabtagene ciloleucel n = 30), between 2018 and 2022. Three patients developed aGvHD, whereas 6 patients developed cGvHD after CAR T-cell. The 100-day cumulative incidence (CI) of new aGvHD was 1.6% and the 12-month CI of new cGvHD was 2.8%. The 1-year GvHD relapse-free survival and non-relapse mortality were 52.1% and 4.7%, respectively. Last, with a median follow up of 18.8 months, the 1-year overall survival was 76.8%. In summary, the GvHD rate in allo-HCT patients treated with CAR T-cell therapy is relatively low. Our data support the view that GvHD is not a major safety issue in this setting.

Details

Original languageEnglish
Pages (from-to)431–437
Number of pages7
JournalLeukemia
Volume39
Issue number2
Early online date19 Nov 2024
Publication statusPublished - Feb 2025
Peer-reviewedYes

External IDs

Scopus 85209650839

Keywords