Different treatment eras for relapsed and refractory primary mediastinal B-cell lymphoma patients: accessibility to CAR T cells is associated with a better prognosis in a pooled analysis of the REPRIME-FIL and the CART-SIE studies.

Authors

Anna Guidetti, Irene Dogliotti, Annalisa Chiappella, Emilio Iannitto, Andrea Evangelista, Anna Dodero, Alice Di Rocco, Monica Balzarotti, Beatrice Casadei, Federica Cavallo, Alessandro Re, Mirko Farina, Stefania Bramanti, Patrizia Chiusolo, Massimo Martino, Maurizio Musso, Manuela Zanni, Giovanni Grillo, Emanuele Ravano, Mauro Krampera, Stefan Hohaus, Maurizio Martelli, Giulia Zacchi, Carlo Visco, Pier Luigi Zinzani, Ugo Consoli, Paolo Corradini

Published in

Haematologica. Sep 24, 2026. Epub Sep 24, 2026.

Abstract

Chimeric Antigen Receptor (CAR) T-cell therapy targeting CD19 has demonstrated efficacy as salvage treatment for patients with relapsed/refractory (R/R) primary mediastinal B-cell lymphoma (PMBCL), however, a direct comparison between CAR T activity and other salvage treatments has not previously been performed. This study aims to compare overall survival (OS) in R/R PMBCL patients treated in different eras who reflect accessibility to CAR T-cells in R/R patient treated after 2019 and treatment with other salvage programs in the years before. We performed a pooled analysis including all pts affected by R/R PMBCL enrolled in the ongoing multicenter prospective observational study CART-SIE and in the retrospective REPRIME-FIL study. A total of 191 patients were included, 87 receiving CAR T cells and 104 treated with other salvage therapies. The 3-year OS from failure of first line treatment for the entire cohort was 62% (95% CI 55-69). The 6-months landmark analysis showed that patients treated with CAR T cells had a significantly reduced risk of death and a superior OS compared with those receiving other regimens (adjusted HR 0.34; 95%CI 0.17-0.66, p=0.001). Patients treated with CAR T cells also had superior OS compared with the subgroup of REPRIME patients who underwent ASCT (adjusted HR 0.27; 95%CI 0.13-0.66, p=0.001). Within the limitations inherent to a pooled analysis, administration of CAR T cells during salvage of R/R PMBCL patients appears to be associated with a longer OS with a risk of death approximately one-third of that observed in patients managed without CAR T.

PMID:
42779302
Bibliographic data and abstract were imported from PubMed on 24 Sep 2026.

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