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. 2024 Apr;30(4):984-989.
doi: 10.1038/s41591-024-02826-w. Epub 2024 Jan 24.

T cell lymphoma and secondary primary malignancy risk after commercial CAR T cell therapy

Guido Ghilardi  1   2   3 , Joseph A Fraietta  2   4 , James N Gerson  1   3 , Vivianna M Van Deerlin  5   6 , Jennifer J D Morrissette  5   6 , Gabriel C Caponetti  5 , Luca Paruzzo  1   2   3 , Jaryse C Harris  5 , Elise A Chong  1   2   3 , Sandra P Susanibar Adaniya  2   3   4 , Jakub Svoboda  1   2   3 , Sunita D Nasta  1   2   3 , Ositadimma H Ugwuanyi  1   2   3 , Daniel J Landsburg  1   3 , Eugenio Fardella  1   2   3 , Adam J Waxman  2   3   4 , Emeline R Chong  1   2   3 , Vrutti Patel  1   2   3 , Raymone Pajarillo  1   2   3 , Irina Kulikovskaya  2 , David B Lieberman  5   6 , Adam D Cohen  2   3   4 , Bruce L Levine  2 , Edward A Stadtmauer  2   3   4 , Noelle V Frey  2   3   4 , Dan T Vogl  2   3   4 , Elizabeth O Hexner  2   3   4 , Stefan K Barta  1   2   3 , David L Porter  2   3   4 , Alfred L Garfall  2   3   4 , Stephen J Schuster  1   2   3 , Carl H June  2 , Marco Ruella  7   8   9   10   11
Affiliations

T cell lymphoma and secondary primary malignancy risk after commercial CAR T cell therapy

Guido Ghilardi et al. Nat Med. 2024 Apr.

Abstract

We report a T cell lymphoma (TCL) occurring 3 months after anti-CD19 chimeric antigen receptor (CAR) T cell immunotherapy for non-Hodgkin B cell lymphoma. The TCL was diagnosed from a thoracic lymph node upon surgery for lung cancer. The TCL exhibited CD8+ cytotoxic phenotype and a JAK3 variant, while the CAR transgene was very low. The T cell clone was identified at low levels in the blood before CAR T infusion and in lung cancer. To assess the overall risk of secondary primary malignancy after commercial CAR T (CD19, BCMA), we analyzed 449 patients treated at the University of Pennsylvania. At a median follow-up of 10.3 months, 16 patients (3.6%) had a secondary primary malignancy. The median onset time was 26.4 and 9.7 months for solid and hematological malignancies, respectively. The projected 5-year cumulative incidence is 15.2% for solid and 2.3% for hematological malignancies. Overall, one case of TCL was observed, suggesting a low risk of TCL after CAR T.

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References

    1. US FDA. FDA Investigating Serious Risk of T-cell Malignancy Following BCMA-Directed or CD19-Directed Autologous Chimeric Antigen Receptor (CAR) T cell Immunotherapies https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologi... (2023).
    1. Thomas, A. et al. Second malignancies after multiple myeloma: from 1960s to 2010s. Blood 119, 2731–2737 (2012). - PubMed - PMC - DOI
    1. Travis, L. B. et al. Second cancers among long-term survivors of non-Hodgkin′s lymphoma. J. Natl Cancer Inst. 85, 1932–1937 (1993). - PubMed - DOI
    1. Sacchi, S. et al. Secondary malignancies after treatment for indolent non-Hodgkin′s lymphoma: a 16-year follow-up study. Haematologica 93, 398–404 (2008). - PubMed - DOI
    1. Kim, H. N. et al. Composite follicular lymphoma and classic Hodgkin lymphoma. J. Pathol. Transl. Med. 56, 57–60 (2022). - PubMed - DOI