Long-term therapy outcomes of CD19/22 CAR T-cell alone or with autologous stem cell transplantation for relapsed/refractory DLBCL

Abstract We conducted a comparative analysis of the long-term efficacy and safety of two single-arm trials for relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL): CD19/CD22 chimeric antigen receptor (CAR19/22) T-cell cocktail therapy alone (Trial A) or combined with autologous stem cell transplantation (ASCT) (Trial B). The study included 124 patients not in remission after bridging therapy. Cytopenia (36.92% vs.52.54%) and infection (29.68% vs. 28.81%) were the predominant late grade ≥3 adverse events. Trial B achieved higher overall response rate (best overall response: 93.22% vs. 78.46%, P=0.023) and superior progression-free survival (PFS) (median, 5.68 months vs. not reaching, P<0.001) and overall survival (OS) (median, 27.61 months vs. not reaching, P<0.001) than Trial A. Independent predictors of longer PFS and OS included achieving complete response at 3 months and receiving combination therapy. The associations remained statistically significant after adjustment in sensitivity analyses incorporating propensity score matching and inverse probability of treatment weighting.