Outcomes and factors impacting use of axicabtagene ciloleucel in patients with relapsed or refractory large B-cell lymphoma: results from an intention-to-treat analysis

Agrima Mian, Wei Wei, Allison M. Winter, Jack Khouri, Deepa Jagadeesh, Faiz Anwer, Aaron T. Gerds, Robert M. Dean, Ronald Sobecks, Brad Pohlman, Betty K. Hamilton, Navneet S. Majhail, Brian T. Hill

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Data on real-world outcomes of axicabtagene ciloleucel (axi-cel) therapy for relapsed/refractory large B-cell lymphoma (R/R LBCL) are limited. In this intent to treat (ITT) analysis, we reviewed records of 38 consecutive patients with R/R LBCL for whom axi-cel was intended. Twenty-seven (71%) patients received axi-cel and 11 (29%) did not. Patients in the non-axi-cel group had a higher hematopoietic cell transplantation comorbidity index (HCT-CI) (median 4 vs. 2, p =.04). Median overall survival for the ITT, axi-cel and non-axi-cel group was 10 (95% CI, 3.7 to 13), 13 (95% CI, 7.7 to N.R.) and 1 (95% CI, 0.4 to 3.7) month(s) respectively. Factors limiting axi-cel use were disease progression, sepsis, manufacturing failure and socioeconomic barrier in 6 (55%), 3 (27%), 1 (9%) and 1 (9%) patient(s) respectively. Additional strategies are needed to ensure all LBCL patients for whom chimeric antigen receptor (CAR) T-cell therapy is prescribed can receive this treatment.

Original languageEnglish (US)
Pages (from-to)1344-1352
Number of pages9
JournalLeukemia and Lymphoma
Volume62
Issue number6
DOIs
StatePublished - 2021
Externally publishedYes

Keywords

  • Axi-cel
  • CAR T-cell therapy
  • diffuse large B-cell lymphoma
  • letter of medical necessity

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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