Advances in cellular and humoral immunotherapy – implications for the treatment of poor risk childhood, adolescent, and young adult B‐cell non‐Hodgkin lymphoma

e13630 Background: Hematological malignancies is thought to be one of the more common Adolescent and Young Adult (AYA) cancers and constitute leukemias and lymphomas. However, little is known about its incidence and prevalence in Asia. We also do not have any data on its behavior or its prognosticators. The outcomes of this group of patients is also unknown when compared to the pediatrics or geriatrics, but is expected to be not as ideal. There is no consensus on whether this group of patients should be treated as pediatrics or as the older adults. We have sought to evaluate the prevalence and trends in a single large-volume tertiary cancer centre in Asia. Methods: We extracted data on all patients with cancer between 16-39 years old who were seen at our centre (National Cancer Centre Singapore) during the period of 1st January 2015 and 31st December 2019. In total, we had 2583 patients. We then excluded all other cancer types except those with a hematological malignancy and 5 other patients due to incomplete data. Results: There were 319 patients with a hematological malignancy. 153 (48%) were female and 166 were male(52%). Most of the patients presented between 30-39 years old (171, 53.6%). There were 54 (2.1%) leukemias and 265 (83.1%) lymphomas. Of those with leukemias, 46 (85.2%) had acute leukemia and 9 (14.8%) had chronic leukemias. Among the lymphoma patients, there were 194 (73.2%) Non Hodgkin Lymphoma (NHL) patients and 69 (26.0%) Hodgkin Lymphoma (HL) patients. There were 149 (46.7%) B Cell lymphomas and 38 (11.9%) T Cell lymphoma patients. The most common B cell Lymphomas is Diffuse Large B Cell Lymphoma (128, 85.9%) and the most common T Cell Lymphomas is Peripheral T-cell Lymphoma (28, 73.7% patients). Conclusions: AYAs with a hematological malignancy form a significant portion of the cancers we see in this age group. Yet, little information is available with regards to their clinico-pathological characteristics, especially in Asia. Work is underway to further elucidate these differences so that we can better their outcomes.

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Second international symposium on childhood, adolescent and young adult non-Hodgkin lymphoma. 18-20 May 2006 New York, NY, USA

British Journal of Haematology ◽

10.1111/j.1365-2141.2005.05942.x ◽

2006 ◽

Vol 132 (5) ◽

pp. 667-667

Keyword(s):

New York ◽

Young Adult ◽

International Symposium ◽

Hodgkin Lymphoma ◽

Adolescent And Young Adult ◽

Non Hodgkin Lymphoma ◽

Second International

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CD19 CAR T cells following autologous transplantation in poor-risk relapsed and refractory B-cell non-Hodgkin lymphoma

Blood ◽

10.1182/blood.2018883421 ◽

2019 ◽

Vol 134 (7) ◽

pp. 626-635 ◽

Cited By ~ 17

Author(s):

Craig S. Sauter ◽

Brigitte Senechal ◽

Isabelle Rivière ◽

Ai Ni ◽

Yvette Bernal ◽

...

Keyword(s):

T Cells ◽

T Cell ◽

B Cell ◽

Hodgkin Lymphoma ◽

B Cell Lymphoma ◽

Car T Cells ◽

Poor Risk ◽

Car T Cell ◽

Non Hodgkin Lymphoma ◽

Car T

Abstract High-dose chemotherapy and autologous stem cell transplantation (HDT-ASCT) is the standard of care for relapsed or primary refractory (rel/ref) chemorefractory diffuse large B-cell lymphoma. Only 50% of patients are cured with this approach. We investigated safety and efficacy of CD19-specific chimeric antigen receptor (CAR) T cells administered following HDT-ASCT. Eligibility for this study includes poor-risk rel/ref aggressive B-cell non-Hodgkin lymphoma chemosensitive to salvage therapy with: (1) positron emission tomography–positive disease or (2) bone marrow involvement. Patients underwent standard HDT-ASCT followed by 19-28z CAR T cells on days +2 and +3. Of 15 subjects treated on study, dose-limiting toxicity was observed at both dose levels (5 × 106 and 1 × 107 19-28z CAR T per kilogram). Ten of 15 subjects experienced CAR T-cell–induced neurotoxicity and/or cytokine release syndrome (CRS), which were associated with greater CAR T-cell persistence (P = .05) but not peak CAR T-cell expansion. Serum interferon-γ elevation (P < .001) and possibly interleukin-10 (P = .07) were associated with toxicity. The 2-year progression-free survival (PFS) is 30% (95% confidence interval, 20% to 70%). Subjects given decreased naive-like (CD45RA+CCR7+) CD4+ and CD8+ CAR T cells experienced superior PFS (P = .02 and .04, respectively). There was no association between CAR T-cell peak expansion, persistence, or cytokine changes and PFS. 19-28z CAR T cells following HDT-ASCT were associated with a high incidence of reversible neurotoxicity and CRS. Following HDT-ASCT, effector CD4+ and CD8+ immunophenotypes may improve disease control. This trial was registered at www.clinicaltrials.gov as #NCT01840566.

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