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The following is a summary of “Late Adverse Events After Chimeric Antigen Receptor T-Cell Therapy for Patients With Aggressive B-Cell Non-Hodgkin Lymphoma,” published in the February 2025 issue of Jama Network Open by Camacho-Arteaga et al. 

Acute adverse events (AEs) after chimeric antigen receptor (CAR) T-cell therapy are well known, but long-term effects remain unclear in aggressive B-cell lymphoma. 

Researchers conducted a retrospective study to assess late AEs in adults with large B-cell lymphoma (LBCL) treated with CD19-targeted CAR T cells.  

They conducted a prospective study from September 1, 2018, to December 31, 2022, in 6 Spanish hospitals with 172 adults who received CD19-targeted CAR T-cell therapy for relapsed or refractory LBCL and survived at least 3 months post-infusion and collected late AEs data until patients started new antilymphoma therapy, were lost to follow-up, died, or reached 24 months, starting from the third month post-infusion and including new-onset and persistent AEs.  

The results showed that among 172 patients (mean [SD] age, 58.5 [13.7] years; 101 men [58.7%]), 135 (78.5%) had at least 1 late AE. Infections had the highest incidence (5.6 per 100 person-months [95% CI, 4.5-7.0]), followed by neutropenia (3.6 [95% CI, 2.9-4.5]) and thrombocytopenia (2.2 [95% CI, 1.7-3.0]). Infection rates remained stable, while cytopenias decreased after 6 months. All nonrelapse-related deaths (7) were due to infections. Dermatologic AEs occurred in 23 patients (13.4%), with 88.9% (24 of 27) starting after 3 months. Neurologic AEs were reported in 15 patients (8.7%), cardiovascular AEs in 10 patients (5.8%), and secondary neoplasms in 4 patients (2.3%).  

They found that CAR T-cell therapy had a favorable safety profile, but continuous follow-up was needed as serious AEs occurred years after infusion.  

Source: jamanetwork.com/journals/jamanetworkopen/fullarticle/2830583