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December 8, 2025Blood

Large B-cell lymphoma after CD19-CAR-T failure: Updated real-world outcomes, prognostic factors, and prediction models

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Authors

SKSmith KungwankiattichaiCOCraig OkadaBHBrandon Hayes‐Lattin

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Overview

Retrospective analysis reveals bispecific antibodies improve response rates in large B-cell lymphoma after CD19-CAR-T failure, suggesting new treatment strategies are needed.

Key Points

  • This research aims to evaluate outcomes and prognostic factors following CD19-CAR-T therapy failure in large B-cell lymphoma patients.
  • Conducted a single-center retrospective analysis of R/R LBCL patients treated with CD19-CAR-T at Oregon Health & Science University from 2016 to 2024.
  • Identified patients with documented CAR-T failure and analyzed baseline characteristics, post-relapse features, and treatment outcomes.
  • Evaluated prognostic factors using univariate analysis and developed prediction models for overall survival.
  • Of 187 LBCL patients receiving CD19-CAR-T, 100 experienced treatment failure.
  • Median overall survival after CAR-T failure was 5.06 months, with 68% receiving subsequent therapy showing improved survival (9.95 months vs. 0.76 months).
  • Complete response rates were highest with bispecific antibodies (38%), followed by anti-CD19 agents (33%) and polatuzumab-based regimens (27.8%).

Cite This Study

Kungwankiattichai et al. (2025) studied this question.

synapsesocial.com/papers/69362f694fa91c937236df5fhttps://doi.org/10.1182/blood-2025-3726
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Association of high-grade biology with marked salvage refractoriness following CD19 CAR T-cell therapy failure in large B-cell lymphoma: A systematic review and meta-analysis.2026
  2. 2Clinical and pathological features of patients with large B-cell lymphoma relapsing after CAR T-cell therapy2025 · 1 citations
  3. 3Outcome of patients with large B-cell lymphoma relapsing after second-line CAR-t: Insights from the descar-t registry2025
  4. 4First-line salvage therapies in relapsed/refractory large B-cell lymphoma after second- or third-line CD19-directed CAR T-cell therapy2025
  5. 5Outcomes and salvage strategies for large B‐cell lymphoma progressing after second‐line CAR T‐cell therapy: A DESCAR‐T study from the LYSA group2026