What does this research mean for the field?

Robust day 7 CAR T-cell expansion (≥48 cells/μL) is independently associated with improved progression-free survival and increased toxicity in patients with relapsed/refractory large B-cell lymphoma treated with axicabtagene ciloleucel. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the clinical utility of routine CAR T-cell expansion monitoring and assess its association with survival, toxicity, and treatment response in patients with relapsed/refractory large B-cell lymphoma.

September 8, 2026British Journal of HaematologyOpen Access

Dynamic risk stratification using early CAR ‐T expansion in R/R LBCL treated with axicabtagene ciloleucel

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Authors

BPBrydon PanozzoThe Royal Melbourne Hospital SRSamuel RobinsonThe Royal Melbourne Hospital AMAdrian MinsonThe University of Melbourne

Discussion

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Implication

Cohort study reveals early CAR T-cell expansion predicts survival and toxicity in large B-cell lymphoma, indicating utility for dynamic post-infusion monitoring.

Key Points

To evaluate the clinical utility of routine CAR T-cell expansion monitoring and assess its association with survival, toxicity, and treatment response in patients with relapsed/refractory large B-cell lymphoma.
Retrospective analysis of a prospectively collected cohort of 176 patients with relapsed/refractory large B-cell lymphoma treated with axicabtagene ciloleucel.
Flow cytometry measured CAR T-cell expansion at days 7, 14, and 28 post-infusion, with real-time reporting to clinicians in 111 patients.
Multivariable models evaluated associations between day 7 expansion, baseline risk factors (pre-lymphodepletion lactate dehydrogenase and bridging response), progression-free survival, and toxicities.
Robust day 7 expansion (≥48 cells/μL) was independently associated with improved progression-free survival (HR, 0.43; 95% CI, 0.22–0.83; p = 0.01).
Higher day 7 CAR T-cell expansion was associated with increased cytokine release syndrome severity and higher incidence of immune effector cell-associated neurotoxicity syndrome.
Higher corticosteroid exposure used to manage toxicities was not associated with inferior progression-free survival.

Cite This Study

Panozzo et al. (2026) studied this question.

synapsesocial.com/papers/6a9fd79b58e84d0ff5b46590 https://doi.org/10.1111/bjh.70825

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Implication

Cohort study reveals early CAR T-cell expansion predicts survival and toxicity in large B-cell lymphoma, indicating utility for dynamic post-infusion monitoring.

Dynamic risk stratification using early CAR ‐T expansion in R/R LBCL treated with axicabtagene ciloleucel

Discussion

Member takes

Implication

Key Points

Cite This Study

Dynamic risk stratification using early CAR ‐T expansion in R/R LBCL treated with axicabtagene ciloleucel

Discussion

Member takes

Implication

Key Points

Cite This Study

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