Chimeric Antigen Receptor T-cell Therapy for Richter Transformation: A CIBMTR analysis.

Publication/Presentation Date

8-1-2025

Abstract

Relapsed and/or refractory Richter transformation (RT) is generally associated with poor response to available therapies and short survival time. As RT patients were excluded from participating in the pivotal studies of chimeric antigen receptor T cell therapy (CAR-T) for large B-cell lymphoma, there is paucity of information about the efficacy of CAR-T in RT. Therefore, through the Center for International Blood and Marrow Transplant Research (CIBMTR) registry, we analyzed data from 140 RT patients who received anti-CD19 CAR-T between 2018 and 2023. Patients had received a median of 3 lines of therapy for RT (range:1-8), with nearly 43% being exposed to a Bruton's tyrosine kinase inhibitor and/or venetoclax. Axicabtagene ciloleucel (axi-cel) (65%) and tisagenlecleucel (tisa-cel) (28%) were the commonly prescribed products. Grade ≥3 cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome occurred in 9.4 % and 20%, respectively. After a median follow-up of 25 months (range: 1.8-61.5) from CAR-T infusion, 2-year progression-free and overall survival were 32.5% (95%CI, 24-41) and 46.6% (95%CI, 38-58), respectively. The 2-year cumulative incidence of relapse and non-relapse mortality were 58.8% (95% CI, 50 - 67), and 8.7% (95% CI, 4 - 14%), respectively. Poor performance status and refractory disease before CAR-T infusion were predictive of inferior survival and disease progression. Our results show that anti-CD19 CAR-T can function as an effective treatment modality for a proportion of RT patients.

ISSN

2666-6367

Disciplines

Medicine and Health Sciences

PubMedID

40754223

Department(s)

Department of Medicine, Hematology-Medical Oncology Division

Document Type

Article

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