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<p>Chimeric antigen receptor T-cell (CAR-T) therapy has transformed the management of patients with relapsed/refractory (R/R) hematologic malignancies, including B-cell lymphomas and multiple myeloma (MM). While data pertaining to the efficacy and toxicity associated with CAR-T have been widely reported, there are limited data on long-term complications. We retrospectively analyzed 246 patients treated with CAR-T for R/R B-cell lymphoma (n = 228) and MM (n = 18) at Ohio State University from 2016 to 2022, with a minimum of two years of follow-up. The median age was 66&#xa0;years, and the median number of prior treatments was four. With a median follow-up of 38&#xa0;months (range 11–66), 21 patients (8.5%) developed a second primary malignancy (SPM), with non-melanoma skin cancer being the most common (52%), followed by hematologic malignancies (33%) and non-skin solid tumors (14%). Squamous cell carcinoma accounted for 38% of skin cancers, while myelodysplastic syndrome and acute myeloid leukemia were the predominant hematologic malignancies. Solid tumors included bladder, prostate, and breast cancer. The distinct pattern of SPMs suggests potential CAR-T-related risks, warranting vigilant post-treatment surveillance. Further studies are necessary to elucidate underlying mechanism and predictive factors and guide long-term management of SPM risk in CAR-T survivors.</p>

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Second primary malignancies following CAR T-cell therapy in patients with hematologic malignancies

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月18日

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  • Elvira Umyarova,
  • Charles Pei,
  • William Pellegrino,
  • Qiuhong Zhao,
  • Nidhi Sharma,
  • Don Benson,
  • Francesca Cottini,
  • Evandro Bezerra,
  • Jonathan Brammer,
  • Naresh Bumma,
  • Hannah Choe,
  • Nathan Denlinger,
  • Srinivas Devarakonda,
  • Abdullah Khan,
  • Sam Penza,
  • Ashley Rosko,
  • Sumithira Vasu,
  • Sarah Wall,
  • Lapo Alinari,
  • Robert Baiocchi,
  • David A. Bond,
  • Beth Christian,
  • Walter Hanel,
  • Kami Maddocks,
  • John Reneau,
  • Yazeed Sawalha,
  • Alma Habib,
  • Audrey Sigmund,
  • Timothy J. Voorhees,
  • Marcos de Lima,
  • Narendranath Epperla

摘要

Chimeric antigen receptor T-cell (CAR-T) therapy has transformed the management of patients with relapsed/refractory (R/R) hematologic malignancies, including B-cell lymphomas and multiple myeloma (MM). While data pertaining to the efficacy and toxicity associated with CAR-T have been widely reported, there are limited data on long-term complications. We retrospectively analyzed 246 patients treated with CAR-T for R/R B-cell lymphoma (n = 228) and MM (n = 18) at Ohio State University from 2016 to 2022, with a minimum of two years of follow-up. The median age was 66 years, and the median number of prior treatments was four. With a median follow-up of 38 months (range 11–66), 21 patients (8.5%) developed a second primary malignancy (SPM), with non-melanoma skin cancer being the most common (52%), followed by hematologic malignancies (33%) and non-skin solid tumors (14%). Squamous cell carcinoma accounted for 38% of skin cancers, while myelodysplastic syndrome and acute myeloid leukemia were the predominant hematologic malignancies. Solid tumors included bladder, prostate, and breast cancer. The distinct pattern of SPMs suggests potential CAR-T-related risks, warranting vigilant post-treatment surveillance. Further studies are necessary to elucidate underlying mechanism and predictive factors and guide long-term management of SPM risk in CAR-T survivors.