Antibiotic Use Before CAR-T Treatment Is Associated with Inferior Outcomes in DLBCL Lymphoma Patients

Area of Science:

• Oncology
• Immunology
• Microbiome Research

Background:

• Chimeric antigen receptor (CAR)-T-cell therapy is a vital treatment for relapsed or refractory hematologic malignancies.
• Patient responses to CAR-T-cell therapy vary significantly.
• The gut microbiome may influence CAR-T-cell efficacy, with antibiotics potentially causing dysbiosis and negative outcomes.

Purpose of the Study:

• To investigate the impact of antibiotic therapy before CAR-T-cell infusion on patient outcomes.
• To assess the association between antibiotic exposure and survival in patients undergoing CAR-T-cell therapy.

Main Methods:

• Retrospective analysis of clinical data from 140 patients.
• Stratification into two groups: 67 patients with prior antibiotic exposure and 73 without.
• Evaluation of progression-free survival and overall survival.

Main Results:

• Patients with prior antibiotic exposure showed significantly reduced progression-free survival (p=0.016) and overall survival (p=0.002).
• Multiple antibiotic courses and shorter intervals between antibiotic treatment and CAR-T-cell therapy correlated with poorer outcomes.

Conclusions:

• Pre-CAR-T-cell therapy antibiotic exposure is associated with inferior patient outcomes.
• The causal relationship and role of antibiotic-induced dysbiosis require further investigation, considering potential confounding by patient comorbidities.