Page 110 - Haematologica May 2022

R. Ram et al.
(non-GCB vs. GCB ) and high LDH level, being surrogates for a more aggressive disease, were found to be associated with shorter PFS.14,15 In contrast, prior autograft (indicating the lack of primary refectory disease) and the achievement of CR at 30 days post CAR-T cell therapy predicted durable responses, supporting prior reports.14 The OS in our cohort of patients was also encouraging, approaching 69% at 12 months post CAR-T transfusion. In consensus with prior reports, administration of bridging therapy and high LDH levels were both found to be associated with shorter survival, whereas an achievement of CR at days 30 post CAR-T cell therapy predicted a longer survival.14,15
Our study has several limitations, mainly due to the ret- rospective nature and the relatively small number of patients. In several analyses, data on potential significant factors were missing for all or for some of the patients, e.g., molecular characteristics and T-cell subsets in apheresis bags. Moreover, there were other imbalances between the two groups (i.e., higher percentage of patients with ECOG PS of 3 in the control group and the number of lines prior to CAR-T cell therapy ), which might affect our results and make it difficult to conclude if elderly patients have a worse or a similar outcome to their younger counterparts. Although this cohort represent non-selected real-life elder- ly lymphoma patients, it is possible that presumably “inel- igible” patients were not referred for CAR-T cell therapy and thus our population is still relatively “selective”.
Nevertheless, in order to overcome the potential bias of age we performed matched control cohort analysis with younger counterparts and indeed showed that age in itself should not preclude elderly patients from undergoing CAR-T cell therapy. Ideally, a geriatric scoring assessment should be employed and help to establish eligibility criteria for CAR-T cell therapy in this aged group pf patients. Future studies should focus on improving the long-term efficacy of the product as well as earlier intervention in cases of progression and active rehabilitation to improve quality of life post therapy in this population.
Disclosures
RR has received honoraria from Novartis and Gilead and has participated in advisory board meeting of Novartis.
Contributions
RR and IA conceived the presented research; RR, SG, LSS, OA, YBO, PS, MY, BA, CP, RG, NS, YH, RG and IA per- formed the clinical activity and collected the clinical data; RR, SG and LSA verified the data; DH, CGS and SK performed the lab- oratory tests and analyses. All authors discussed the results and contributed to the final manuscript.
Funding
None of the authors received financial support for the research, authorship, and/or publication of this article.
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