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Impact of Age on Outcomes after CD19 CAR-T Cell Therapy for Large B-Cell Lymphomas

Mirza, Abu-Sayeef
; 
Hosing, Chitra
; 
Foss, Francine
; 
Kim, Soyoung
; 
Moskop, Amy
; 
Oloyede, Temitope
; 
Abid, Muhammad Bilal
; 
Afrough, Aimaz
; 
Ahmed, Sairah
; 
Badar, Talha
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Author
Mirza, Abu-Sayeef
Hosing, Chitra
Foss, Francine
Kim, Soyoung
Moskop, Amy
Oloyede, Temitope
Abid, Muhammad Bilal
Afrough, Aimaz
Ahmed, Sairah
Badar, Talha
Barba, Pere
Bhatt, Vijaya Raj
Brown, Valerie I.
Dahiya, Saurabh
Deol, Abhinav
Epperla, Narendranath
Ganguly, Siddhartha
Grover, Natalie S.
Hashmi, Hamza
Hashmi, Shahrukh
Hematti, Peiman
Hildebrandt, Gerhard C.
Hill Jr., John M.
Hossain, Nasheed M.
Ibrahim, Uroosa
Johnson, P. Connor
Kharfan-Dabaja, Mohamed A.
Krem, Maxwell M.
Lekakis, Lazaros J.
Maziarz, Richard T.
Murthy, Hemant S.
Riedell, Peter A.
Salas, María Queralt
Shouse, Geoffrey
Strouse, Christopher
Thakar, Monica S.
Turtle, Cameron J.
Woolfrey, Ann
Wudhikarn, Kitsada
Yared, Jean A.
Pasquini, Marcelo C.
Gowda, Lohith
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Department
Computer Vision
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Type
Journal article
Date
2025
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Language
English
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Abstract
Age may influence clinical outcomes after CD19-directed chimeric antigen receptor T cell (CAR-T) therapy. Real-world data on the survival and toxicity outcomes of older patients receiving CAR T-cell therapy are limited. We used data from Center for International Blood and Marrow Transplant Research (CIBMTR) for adults with diffuse large B-cell lymphoma who received a CAR-T from May 2018 to June 2020. Cumulative incidence and severity of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) were reported. Efficacy and safety outcomes were assessed using age as a continuous variable and amongst four age groups: 18-54, 55-64, 65-74, and ≥75 years. Nearly half (44%) of 1916 total recipients were aged 65 or older. Patients received either axicabtagene ciloleucel (75%) or tisagenlecleucel (25%). Overall rates of CRS and ICANS were 75% and 43%, and severe rates of CRS and ICANS were 9% and 21%, respectively. For all patients, 12-month OS, PFS, and relapse rates were 62%, 42%, 55%, respectively. As a continuous variable, older age did not affect OS, PFS and CRS. Risk of ICANS increased with age (hazard ratio [HR], 1.03; P < .001). Beyond age 64, risk for ICANS increases (HR, 1.65; 95% CI, 1.33-2.1; P < .001). In a categorical analysis, the 65-74 age group had lower relapse risk (HR, 0.77; 95% CI, 0.64-0.93; P = .005) than younger patients. CD19 CAR-T therapy is effective for older adults, and older age does not worsen mortality. Older age is associated with higher ICANS risk and should guide patient selection.
Citation
A.-S. Mirza et al., “Impact of Age on Outcomes after CD19 CAR-T Cell Therapy for Large B-Cell Lymphomas,” Blood Neoplasia, p. 100187, Nov. 2025, doi: 10.1016/J.BNEO.2025.100187
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Blood Neoplasia
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Publisher
Elsevier
DOI
10.1016/J.BNEO.2025.100187
Additional links
https://www.sciencedirect.com/science/article/pii/S2950328025001220
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