CAR T-Cell Therapy in the Older Person: Indications and Risks.
Geoffrey ShouseAlexey V DanilovAndy ArtzPublished in: Current oncology reports (2022)
The most robust data in older adults are among relapsed and refractory (r/r) diffuse large B-cell lymphoma (DLBCL) patients where three products are available with the longest clinical follow up and the most abundant real-world evidence (RWE). Data for the approved CART products for follicular lymphoma (FL) and mantle cell lymphoma (MCL) are relatively new and RWE is lacking in general. Data for CART products in multiple myeloma (MM) and B-cell acute lymphoblastic leukemia (B-ALL) are even more recent, but preliminary data in older adults seem to follow the trend of excellent efficacy in this age group with age-stratified toxicity data limited. Landmark trials and RWE studies indicate that the high response rates of CART for older adult patients, age 65 years and older, are maintained, while toxicity may be amplified. Clinically important toxicities include grade 3 or higher cytokine release syndrome (CRS), neurotoxicity, and infections.
Keyphrases
- diffuse large b cell lymphoma
- acute lymphoblastic leukemia
- electronic health record
- physical activity
- cell therapy
- big data
- multiple myeloma
- end stage renal disease
- chronic kidney disease
- oxidative stress
- epstein barr virus
- ejection fraction
- stem cells
- community dwelling
- acute myeloid leukemia
- data analysis
- climate change
- peritoneal dialysis
- case report
- risk assessment
- deep learning
- bone marrow