Real-World Characterization of Toxicities and Medication Management in Recipients of CAR T-Cell Therapy for Relapsed or Refractory Large B-Cell Lymphoma in Nova Scotia, Canada.

Publisher: MDPI Country of Publication: Switzerland NLM ID: 9502503 Publication Model: Electronic Cited Medium: Internet ISSN: 1718-7729 (Electronic) Linking ISSN: 11980052 NLM ISO Abbreviation: Curr Oncol Subsets: MEDLINE

Publication: 2021- : Basel, Switzerland : MDPI
Original Publication: Toronto : Multimed, c1994-

Immunotherapy, Adoptive*/methods ; Immunotherapy, Adoptive*/adverse effects; Humans ; Nova Scotia ; Middle Aged ; Male ; Female ; Aged ; Retrospective Studies ; Adult ; Lymphoma, Large B-Cell, Diffuse/therapy ; Biological Products/therapeutic use ; Cytokine Release Syndrome/etiology ; Neurotoxicity Syndromes/etiology

Nova Scotia (NS) began offering CAR T-cell therapy as a third-line standard of care for eligible patients with relapsed or refractory large B-cell lymphoma (r/r LBCL) in 2022. Recipients of CAR T-cell therapy often experience acute toxicities, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), which require close monitoring and prompt management. This retrospective review aimed to describe the characteristics of adult patients with r/r LBCL deemed eligible to receive CAR T-cell therapy with axicabtagene ciloleucel in NS between January 2022 and June 2024, the toxicities experienced and toxicity management, hospital visits and intensive care unit (ICU) admissions, the utilization of toxicity management guidelines, and general efficacy outcomes. Twenty-seven patients received axicabtagene ciloleucel. All patients experienced CRS (7.4% grade ≥ 3), and 55.6% developed ICANS (25.9% grade ≥ 3). The median hospital stay was 18 days, with 40.7% requiring ICU admission. There was one treatment-related mortality. Most CRS (85.2%) and ICANS (80.0%) cases were managed according to the guidelines. By day +100, the best objective response rate was 81.5% (44.4% complete responses). Patients who received CAR T-cell therapy in NS, Canada, experienced comparable toxicities and efficacy to those reported in pivotal clinical trials and other real-world experiences.

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Keywords: CAR T-cell therapy; axicabtagene ciloleucel; guideline adherence; guideline utilization; large B-cell lymphoma; toxicity management

U2I8T43Y7R (axicabtagene ciloleucel)
0 (Biological Products)

Date Created: 20250124 Date Completed: 20250124 Latest Revision: 20250130

20250130

PMC11764397

10.3390/curroncol32010002

39851918