[Articles] Treatment of non-Hodgkin lymphoma with point-of-care manufactured CAR T cells: a dual institution, phase 1 trial

Point-of-care CAR T-cell manufacture was feasible and replicable across sites. MB-CART-19 has a safety profile comparable to other CAR T-cell products and high response rates. The recommended phase 2 dose is 2 × 106 MB-CART-19 cells/kg. Short CAR T-cell manufacturing time permits treatment of patients with rapidly progressive lymphoma, a group of patients with high risk disease for whom access to autologous immune effector cellular therapies is usually limited.

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Marzo 2025

Transplant-Free Approach in Relapsed Hodgkin Lymphoma in Children, Adolescents, and Young Adults

This nonrandomized clinical trial evaluates a risk-stratified, response-adapted, transplant-free approach for treatment of children, adolescents, and young adults with low-risk relapsed classic Hodgkin lymphoma with nivolumab plus brentuximab vedotin followed by brentuximab vedotin plus bendamustine for patients with suboptimal response and involved-site radiotherapy.

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Marzo 2025

Nontransplant Treatment for Relapsed Pediatric Hodgkin Lymphoma—Less Is More

Current up-front therapeutic approaches for classic Hodgkin lymphoma (cHL) in children and young adults aim to reduce treatment intensity to minimize long-term treatment-related morbidity. This strategy assumes that patients who relapse can still achieve durable remission with a combination of high-dose chemotherapy (HDC) and autologous stem cell transplant (ASCT). Although this goal is achievable for most children and young adults with relapsed cHL, it comes at the cost of significant nonrelapse morbidity, which can shorten life expectancy and compromise quality of life. ASCT is known to have a 9.6-fold increased late mortality compared with the general population, and nonrelapse mortality accounts for 56% of deaths more than 2 years after autologous hematopoietic cell transplant. This understanding fueled the interest and multiple clinical attempts to identify patients with relapsed and therapy-refractory cHL who could be salvaged without HDC/ASCT and with measurable success. This Editorial reviews the latest transplant-free salvage strategies for relapsed cHL in children and young adults, potentially redefining the existing standard-of-care protocols.

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Marzo 2025

Abstract 4141352: Can quantifiable aortic or coronary artery calcifications in the standard of care baseline CT or PET-CT scan of patients with Hodgkin or non-Hodgkin lymphoma serve as a predictor of Major Adverse Cardiovascular Events?

Circulation, Volume 150, Issue Suppl_1, Page A4141352-A4141352, November 12, 2024. Background:Major adverse cardiovascular events (MACE), including myocardial infarction, acute coronary syndrome, ischemic heart disease requiring revascularization, stroke, and heart failure, have been documented as significant contributors to mortality in cancer survivors. Coronary artery calcium (CAC) can predict MACE in non-cancer populations, while calcium in the aorta (CA) has not been evaluated as a prognostic marker. Every patient diagnosed with cancer undergoes a standard-of-care Positron Emission Tomography-Computed Tomography (PET-CT) or a chest CT before the initiation of chemotherapy.Hypothesis:To determine whether the CAC or CA of patients with Hodgkin’s or non-Hodgkin’s lymphoma, derived from standard-of-care PET-CT/chest CT, can predict the incidence of MACE.Methods:Patients treated with anthracycline-based chemotherapy, diagnosed and followed from January 1, 2013, through June 30, 2023, were included. Patients who did not undergo a PET-CT or CT, and/or developed MACE before treatment initiation were excluded. Univariate and multivariate adjusted Cox regression models were employed to assess whether the presence of CAC, CA, or CAC-CA was associated with the development of MACE. Calcium was retrospectively quantified using TeraRecon software (Durham NC) and categorized as: 0, 1-99, and >100. Outcome analyses was estimated using the Kaplan-Meier method.Results:326 patients were included, mean age of 55 years (range: 52-60), predominantly male 201 (61%) and white 314 (96%), CAC was found in 89 patients and CA in 140. In the univariate regression model, a statistically significant association was found with values >100 for CA, CAC and CAC-CA with the risk of MACE. (Fig 1a/b/c). CAC equal to 0 demonstrated a significant protective effect against MACE. (Fig 1a). In the multivariable analysis, these associations persisted even after adjusting for comorbidities. (Table 1).Conclusion:CAC, CA and CAC/CA >100 in the standard-of-care CT/PET CT are predictors of MACE in lymphoma patients undergoing anthracycline treatment, a CAC equal to 0 has protective effect, these relationships remained statistically significant after adjusting for comorbidities.

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Novembre 2024