一项针对有或无组织学转化的滤泡性淋巴瘤患者进行嵌合抗原受体T细胞疗法的回顾性队列研究。

A retrospective cohort study of chimeric antigen receptor T-Cell therapy in follicular lymphoma patients with or without histological transformation.

作者信息

Wang Jingjing, Zeng Liangyu, Ma Xiao, Xu Ting, Wu Depei, Li Caixia

机构信息

National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.

Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.

出版信息

Ann Hematol. 2025 Jun 2. doi: 10.1007/s00277-025-06428-5.

DOI:10.1007/s00277-025-06428-5

PMID:40455259

Abstract

BACKGROUND

Follicular lymphoma (FL), one of the most common indolent lymphomas, is still classified as an incurable disease. Adverse outcomes in FL frequently occur in patients who experience early relapse or histological transformation to aggressive lymphoma. Chimeric antigen receptor T-cell therapy (CAR-T) has received approval for the treatment of relapsed/refractory B-cell lymphoma.

METHODS

This retrospective study presents the clinical characteristics and treatment follow-up of 26 patients with transformed or relapsed/refractory FL who received CAR-T therapy. It evaluates the efficacy of CAR-T and assesses treatment lines, LDH levels, remission status before treatment, and the histological transformation of their prognostic impact.

RESULTS

Among the 14 transformed FL patients, there was one treatment-related death, the overall response rate (ORR) was 92.0%, with a 2-year progression-free survival (PFS) rate of 66.7% and an overall survival (OS) rate of 73.3%. For the 12 relapsed/refractory FL patients, the ORR was 100.0%, with a 2-year PFS rate of 75.0% and an OS rate of 100.0%, which is higher than that for transformed FL. A favorable remission state before CAR-T treatment correlated with improved PFS (P = 0.009). Compared to transformed patients, those with relapsed/refractory FL exhibited better OS following CAR-T treatment (P = 0.04).

CONCLUSION

CAR-T therapy shows significant efficacy and safety for treating relapsed/refractory follicular lymphoma and transformed lymphoma. Further research should focus on identifying prognostic factors, extending remission duration, and preventing recurrence.

摘要

背景

滤泡性淋巴瘤（FL）是最常见的惰性淋巴瘤之一，目前仍被归类为不可治愈的疾病。FL患者的不良预后通常发生在早期复发或组织学转化为侵袭性淋巴瘤的患者中。嵌合抗原受体T细胞疗法（CAR-T）已获批用于治疗复发/难治性B细胞淋巴瘤。

方法

本回顾性研究介绍了26例接受CAR-T治疗的转化型或复发/难治性FL患者的临床特征和治疗随访情况。评估了CAR-T的疗效，并评估了治疗线数、乳酸脱氢酶（LDH）水平、治疗前的缓解状态及其对预后影响的组织学转化情况。

结果

在14例转化型FL患者中，有1例与治疗相关的死亡，总缓解率（ORR）为92.0%，2年无进展生存率（PFS）为66.7%，总生存率（OS）为73.3%。对于12例复发/难治性FL患者，ORR为100.0%，2年PFS率为75.0%，OS率为100.0%，高于转化型FL患者。CAR-T治疗前的良好缓解状态与PFS改善相关（P = 0.009）。与转化型患者相比，复发/难治性FL患者在接受CAR-T治疗后的OS更好（P = 0.04）。