Anti-CD19 CAR T Cells in CNS Diffuse Large-B-Cell Lymphoma

Abstract

Chimeric antigen receptor (CAR) T-cells targeting CD19 have emerged as a leading engineered T-cell therapy for relapsed/refractory B-cell non-Hodgkins lymphoma (B-NHL). The phase I/II clinical trials that led to FDA approval excluded patients with central nervous system (CNS) involvement, due to strict eligibility criteria. Here we report on our institutional experience with 8 secondary CNS lymphoma patients treated with commercial tisagenlecleucel. No patient experienced >grade 1 neurotoxicity and no patient required tocilizumab or steroids for CAR-T mediated toxicities. Biomarker analysis suggested CAR-T cell expansion despite the absence of systemic disease and early response assessments demonstrated activity of intravenously infused CAR-T cells within the CNS space.