Outcomes Among Adult Recipients of CAR T-cell Therapy for Burkitt Lymphoma

• Despite having relatively favorable disease kinetics, patients with relapsed/refractory BL who receive CAR T-cells have poor outcomes.

• Future trials are needed to determine the optimal treatment of patients with BL for whom CD19-directed CAR T-cell therapy is an option

Burkitt lymphoma (BL) is an aggressive B-cell lymphoma associated with poor outcomes in patients with relapsed/refractory disease. This multicenter, retrospective study evaluated real-world CD19 CAR T-cell therapy outcomes in patients with relapsed/refractory BL using data abstracted from the medical records. In total, 31 patients received CAR T-cells after a median of 3 prior therapies (range 1-6). Patients received axi-cel (n = 19), liso-cel (n = 4), tisa-cel (n = 4) or other agents (n = 4). Grade 1-2 CRS occurred in 83.9% of patients (grade ≥3 6.5%), and grade 1-2 ICANS occurred in 29% of patients (grade ≥3 19.4%). Twenty-eight-day mortality was 16.1%, including one patient who died from grade 5 ICANS. The overall response rate at 1 month was 58.0% with a complete response (CR) rate of 41.9%, however the 6-month CR rate was only 25.8%. Median progression-free survival was 2.3 months (95% CI 1.0 - 9.0), and median overall survival was 6.0 months (95% CI 1.9 - 11.5). Three patients (9.7%) received consolidative allogeneic stem cell transplants, but all subsequently relapsed. In conclusion, CD19 CAR T-cell therapy infrequently delivers long term disease control in BL. Further investigation is needed to determine the most effective alternative management of these patients.