Baseline characteristics of 38 patients who progressed and 18 patients without disease progression after CAR T-cell therapy
| Characteristic . | Relapse after CAR T-cells, n = 38 . | No relapse after CAR T-cells, n = 18 . | P . |
|---|---|---|---|
| Median age at CD19 CAR T-cell therapy (range), y | 42.5 (23-74) | 55 (23-68) | .21 |
| Male sex | 28 (73.7%) | 14 (77.8%) | 1.00 |
| Median lines of treatment before CAR T-cell therapy (range) | 3 (2-7) | 2 (1-7) | .02 |
| Philadelphia chromosome–positive ALL (%) p190 p210 | 13 (34.2) 8 (21.1) 5 (13.1) | 4 (22.2) 3 (16.7) 1 (5.6) | .74 |
| Prior treatment with noncellular immunotherapy*(%) Blinatumomab Inotuzumab ozogamicin | 10 (26.3) 3 (7.9) | 3 (16.7) 1 (5.6) | 1.00 |
| Prior HSCT before CAR T-cell therapy (%) | 17 (44.7) | 3 (16.7) | .11 |
| Bridging therapy†(%) Intensive therapy Nonintensive therapy None | 10 (26.3) 21 (55.3) 7 (18.4) | 10 (55.6) 7 (38.9) 1 (5.6) | .12 |
| Disease burden before CAR T-cell therapy (%) Morphologic disease MRD No evidence of disease | 26 (68.4) 11 (28.9) 1 (2.6) | 5 (27.8) 6 (33.3) 6 (33.3) | .01 |
| CRS post-CAR T-cell therapy (%) Grade 3 or higher CRS‡ | 32 (84.2) 9 (23.7) | 16 (88.9) 6 (33.3) | .52 |
| ICANS (%) Grade 3 or higher ICANS | 22 (57.9) 14 (36.8) | 12 (66.7) 10 (55.6) | .19 |
| Tocilizumab for CRS/ICANS management (%) | 15 (39.5) | 5 (27.8) | .39 |
| Systemic corticosteroid for CRS/ICANS management (%) | 12 (31.6) | 7 (38.9) | .59 |
| Median time from CAR T-cell infusion to corticosteroid (range, d) | 7 (5-15) | 8 (3-12) | .80 |
| Median duration of systemic corticosteroid (range, d) | 7 (1-15) | 9 (2-27) | .16 |
| Median dose intensity of steroid (prednisone equivalent, mg/kg/d) | 1.37 (0.72-2.58) | 1.54 (0.79-6.75) | .38 |
| HSCT consolidation after CAR T-cell therapy (%) | 6 (15.8) | 9 (50.0) | .10 |
| Characteristic . | Relapse after CAR T-cells, n = 38 . | No relapse after CAR T-cells, n = 18 . | P . |
|---|---|---|---|
| Median age at CD19 CAR T-cell therapy (range), y | 42.5 (23-74) | 55 (23-68) | .21 |
| Male sex | 28 (73.7%) | 14 (77.8%) | 1.00 |
| Median lines of treatment before CAR T-cell therapy (range) | 3 (2-7) | 2 (1-7) | .02 |
| Philadelphia chromosome–positive ALL (%) p190 p210 | 13 (34.2) 8 (21.1) 5 (13.1) | 4 (22.2) 3 (16.7) 1 (5.6) | .74 |
| Prior treatment with noncellular immunotherapy*(%) Blinatumomab Inotuzumab ozogamicin | 10 (26.3) 3 (7.9) | 3 (16.7) 1 (5.6) | 1.00 |
| Prior HSCT before CAR T-cell therapy (%) | 17 (44.7) | 3 (16.7) | .11 |
| Bridging therapy†(%) Intensive therapy Nonintensive therapy None | 10 (26.3) 21 (55.3) 7 (18.4) | 10 (55.6) 7 (38.9) 1 (5.6) | .12 |
| Disease burden before CAR T-cell therapy (%) Morphologic disease MRD No evidence of disease | 26 (68.4) 11 (28.9) 1 (2.6) | 5 (27.8) 6 (33.3) 6 (33.3) | .01 |
| CRS post-CAR T-cell therapy (%) Grade 3 or higher CRS‡ | 32 (84.2) 9 (23.7) | 16 (88.9) 6 (33.3) | .52 |
| ICANS (%) Grade 3 or higher ICANS | 22 (57.9) 14 (36.8) | 12 (66.7) 10 (55.6) | .19 |
| Tocilizumab for CRS/ICANS management (%) | 15 (39.5) | 5 (27.8) | .39 |
| Systemic corticosteroid for CRS/ICANS management (%) | 12 (31.6) | 7 (38.9) | .59 |
| Median time from CAR T-cell infusion to corticosteroid (range, d) | 7 (5-15) | 8 (3-12) | .80 |
| Median duration of systemic corticosteroid (range, d) | 7 (1-15) | 9 (2-27) | .16 |
| Median dose intensity of steroid (prednisone equivalent, mg/kg/d) | 1.37 (0.72-2.58) | 1.54 (0.79-6.75) | .38 |
| HSCT consolidation after CAR T-cell therapy (%) | 6 (15.8) | 9 (50.0) | .10 |
One patient received both blinatumomab and inotuzumab ozogamicin before CD19 CAR T-cell therapy.
Intensive therapy included multiagent, myelosuppressive, chemotherapy-based regimen, and nonintensive regimen included nonmyelosuppressive chemotherapy or antibody-based therapy (eg, blinatumomab, inotuzumab). Breakdown of bridging intensity according to disease burden is provided in supplemental Figure 1.
Per American Society of Transplant and Cellular Therapy criteria.