CAR T-cell therapy for relapsed and refractory B-cell non-Hodgkin lymphoma: a single-centre 5-year real-world experience study at Ghent University Hospital

BACKGROUND: Relapsed or refractory (R/R) B-cell non-Hodgkin lymphoma (B-NHL) remains challenging to treat, particularly in patients ineligible for high-dose chemotherapy and autologous stem cell transplantation. Chimeric antigen receptor (CAR) T-cell therapy has emerged as a promising treatment. AIMS: We describe the epidemiology, demographics and outcomes of patients receiving CAR T-cell therapy for R/R DLBCL (including transformed follicular lymphoma [TFL]), high-grade B-cell lymphoma (HGBCL) and mantle cell lymphoma (MCL) at Ghent University Hospital between 2019 and 2024. We assessed associations between disease subtype, remission status, acute toxicity and survival. METHODS: =10). The objective response rate (ORR) at 1 month was 85.6%, with a complete response (CR) rate of 49.4%. At a median follow-up of 11.7 months, ORR increased to 90.3% and CR to 68.7%. Median overall survival was 29.9 months. Patients achieving PR/CR at 1 month had significantly improved long-term survival (p=0.002). Lower total metabolic tumor volume at infusion was associated with a trend toward better survival. Cytokine release syndrome (CRS) occurred in 90.4%, predominantly low grade, with grade 3-4 CRS in 1.2%. Immune effector cell-associated neurotoxicity syndrome (ICANS) occurred in 65.1%, with grade 3-4 events in 15.6%. CONCLUSION: This real-world cohort confirms high response rates and favorable survival following CAR T-cell therapy in R/R B-NHL and explores potential predictive markers associated with long-term survival.