Skip to main content

ORIGINAL RESEARCH article

Front. Oncol.
Sec. Radiation Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1425506

Prevalence of Non-Hodgkin Lymphoma Patients at High-risk of Failure After CAR T-cell Therapy Eligible for Bridging Radiation Therapy

Provisionally accepted
Adnan Danish Adnan Danish 1*Alexandra Della Pia Alexandra Della Pia 1Lindsay Fogel Lindsay Fogel 2Hassan Alkhatatneh Hassan Alkhatatneh 3*Charles Zhao Charles Zhao 2*Tony Varughese Tony Varughese 4*Karine A. Al Feghali Karine A. Al Feghali 5Lauren Pascual Lauren Pascual 1*Brittany Sinclaire Brittany Sinclaire 1*Michael Marafelias Michael Marafelias 1*Joshua Zenreich Joshua Zenreich 1*YenHong Kuo YenHong Kuo 4*Tatyana A. Feldman Tatyana A. Feldman 1,2,4*Yi Zhang Yi Zhang 6*Andre Goy Andre Goy 1,2,4Andrew Ip Andrew Ip 1,2,4Scott D. Rowley Scott D. Rowley 1,4,7*
  • 1 John Theurer Cancer Center, Hackensack, NJ, United States
  • 2 Hackensack Meridian School of Medicine, Nutley, United States
  • 3 Englewood Hospital and Medical Center, Englewood, New Jersey, United States
  • 4 Hackensack University Medical Center, Hackensack, New Jersey, United States
  • 5 RefleXion Medical (United States), Hayward, California, United States
  • 6 Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, New Jersey, United States
  • 7 School of Medicine, Georgetown University, Washington, D.C., District of Columbia, United States

The final, formatted version of the article will be published soon.

    Background and purpose: To determine the prevalence of relapsed or refractory (R/R) non-Hodgkin lymphoma (NHL) patients meeting high-risk criteria for early relapse after CD19 CAR T-cell therapy (CART) who have disease encompassable in a standard radiation therapy (RT) plan (defined as <5 malignant lesions) and may benefit from bridging RT prior to CD19 CART. Materials and methods: This is a single-center, retrospective study of patients with R/R NHL who received CD19 CART from 2018 to 2022. Eligible patients had pre-apheresis radiologic studies available. All patients were classified by number of lesions and history of high-risk disease criteria: bulky disease ≥10 cm, ≥1 extranodal (EN) sites, LDH ≥normal, or ≥1 lesion with SUVmax ≥10. Results: Eighty-one R/R NHL patients were evaluated. Based on our definition, 40 (49%) patients would have been eligible for bridging RT, including 38 patients who met high-risk criteria: 31 with ≥1 EN site, 19 had ≥1 lesion with SUVmax ≥10, 16 with bulky disease, and 3 with elevated LDH. At 3 months after CART, ORRs in high-risk patients with <5 lesions, ≥5 lesions, and no lesions on pre-apheresis studies were 76% (CR 69%, PR 7%), 70% (CR 60%, PR 10%), and 80% (CR 80%), respectively. Conclusion: Approximately 47% (38/81) patients were classified as at high-risk of relapse after CART with disease encompassable in a standard radiation plan and eligible for bridging RT studies.

    Keywords: CD19 CAR T-cell therapy, Relapsed or Refractory Non-Hodgkin Lymphoma (R/R NHL), Bridging Radiotherapy, Bridging therapy, Radiotherapy

    Received: 29 Apr 2024; Accepted: 26 Jul 2024.

    Copyright: © 2024 Danish, Della Pia, Fogel, Alkhatatneh, Zhao, Varughese, Al Feghali, Pascual, Sinclaire, Marafelias, Zenreich, Kuo, Feldman, Zhang, Goy, Ip and Rowley. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Adnan Danish, John Theurer Cancer Center, Hackensack, NJ, United States
    Hassan Alkhatatneh, Englewood Hospital and Medical Center, Englewood, New Jersey, United States
    Charles Zhao, Hackensack Meridian School of Medicine, Nutley, United States
    Tony Varughese, Hackensack University Medical Center, Hackensack, New Jersey, United States
    Lauren Pascual, John Theurer Cancer Center, Hackensack, NJ, United States
    Brittany Sinclaire, John Theurer Cancer Center, Hackensack, NJ, United States
    Michael Marafelias, John Theurer Cancer Center, Hackensack, NJ, United States
    Joshua Zenreich, John Theurer Cancer Center, Hackensack, NJ, United States
    YenHong Kuo, Hackensack University Medical Center, Hackensack, New Jersey, United States
    Tatyana A. Feldman, John Theurer Cancer Center, Hackensack, NJ, United States
    Yi Zhang, Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, 07110, New Jersey, United States
    Scott D. Rowley, John Theurer Cancer Center, Hackensack, NJ, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.