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Updated: Aug 8, 2026
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A Syngeneic Mouse B-Cell Lymphoma Model for Pre-Clinical Evaluation of CD19 CAR T Cells
Published on: October 16, 2018
Large B-Cell Lymphoma After CD19 CAR-T Failure: Updated Real-World Outcomes, Prognostic Factors, and Prediction
Smith Kungwankiattichai1, Sanjog Bastola2, Manoj Rai2
1Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA; Division of Hematology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Transplantation and Cellular Therapy
|August 6, 2026
Summary
Outcomes after chimeric antigen receptor T-cell (CAR-T) therapy failure in large B-cell lymphoma (LBCL) are poor. A new clinical prediction model aids risk stratification for patients receiving subsequent therapies.
Area of Science:
- Hematology
- Oncology
- Immunotherapy
Background:
- Outcomes for relapsed or refractory large B-cell lymphoma (LBCL) after CD19-directed chimeric antigen receptor T-cell (CAR-T) therapy failure are poor.
- Prognostic tools to guide management after CAR-T failure are limited.
Purpose of the Study:
- To evaluate real-world outcomes following CAR-T therapy failure in LBCL.
- To develop clinical prediction models (CPMs) for survival after subsequent anti-cancer therapy.
Main Methods:
- Retrospective cohort study of 187 adult LBCL patients treated with CD19-directed CAR-T therapy.
- Analysis of overall survival (OS) from relapse/progression (OS1) and from subsequent therapy initiation (OS2).
- Development of CPMs using Cox proportional hazards models for 1-year OS.
Main Results:
- 100 patients (53%) experienced CAR-T failure; 68 received subsequent therapy.
- Median OS1 was 5.07 months; subsequent therapy significantly improved OS (9.94 vs. 0.74 months).
- The best CPM included time to subsequent therapy, LDH, and ECOG PS (c-statistic=0.771).
Conclusions:
- LBCL outcomes post-CAR-T failure remain poor despite salvage options.
- Time to relapse after CAR-T is a strong prognostic factor.
- CPMs may aid risk stratification and clinical decision-making for LBCL patients post-CAR-T failure.
