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Circulating CAR T-Cells After Treatment With Axicabtagene Ciloleucel in Patients With Relapsed/Refractory Aggressive B-Cell Lymphomas and Its Association to Treatment Outcome

Werne, Louise Olsson LU orcid ; Elmér, Evelina LU orcid ; Lisak, Mikael ; Pálmason, Róbert LU ; Hult, Annika K LU ; Dykes, Josefina LU and Jerkeman, Mats LU (2026) In European Journal of Haematology p.1-8
Abstract

OBJECTIVES: This study investigates the expansion of CAR T-cells and its association to treatment outcome.

METHODS: Patients with aggressive B-cell lymphomas treated with anti-CD19 CAR T-cell therapy axicabtagene ciloleucel (axi-cel) at Skåne and Sahlgrenska University Hospitals from 2019 to October 2024 were included. CAR T-cells in peripheral blood were measured by flow cytometry. Association between maximum levels of CAR T-cells and response, progression-free survival, overall survival, cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) were investigated.

RESULTS: Peak CAR T-cell levels were higher among patients with complete response (CR) at Day 30 (p = 0.013) and at 12... (More)

OBJECTIVES: This study investigates the expansion of CAR T-cells and its association to treatment outcome.

METHODS: Patients with aggressive B-cell lymphomas treated with anti-CD19 CAR T-cell therapy axicabtagene ciloleucel (axi-cel) at Skåne and Sahlgrenska University Hospitals from 2019 to October 2024 were included. CAR T-cells in peripheral blood were measured by flow cytometry. Association between maximum levels of CAR T-cells and response, progression-free survival, overall survival, cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) were investigated.

RESULTS: Peak CAR T-cell levels were higher among patients with complete response (CR) at Day 30 (p = 0.013) and at 12 months (p = 0.036). CD8+ CAR T-cells were higher in patients with CR (median 135.7, IQR 52.8-433.9) compared to patients not obtaining CR (median 23.2, IQR 11.1-103.3) (p = 0.003). The ratio of CD4+:CD8+ CAR T-cells was lower in patients obtaining CR (p = 0.046). Patients with CAR T-cells above 52.4 CAR T-cells/μL showed superior progression-free survival (p < 0.001).

CONCLUSION: Our study indicates that CAR T-cell levels after axi-cel correlate to durable response, progression-free survival, and that expansion of CD8+ CAR T-cells might be of specific importance for efficacy. Potentially, CAR T-cell levels may be used to enable early detection of patients with high risk of CAR T-cell treatment failure.

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Please use this url to cite or link to this publication:
author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
European Journal of Haematology
pages
1 - 8
publisher
Wiley-Blackwell
external identifiers
  • pmid:41923554
  • scopus:105034854284
ISSN
1600-0609
DOI
10.1111/ejh.70185
language
English
LU publication?
yes
additional info
© 2026 The Author(s). European Journal of Haematology published by John Wiley & Sons Ltd.
id
62925565-5e26-4d87-b45a-da2b6bf2c9d7
date added to LUP
2026-04-23 09:35:53
date last changed
2026-05-22 05:52:07
@article{62925565-5e26-4d87-b45a-da2b6bf2c9d7,
  abstract     = {{<p>OBJECTIVES: This study investigates the expansion of CAR T-cells and its association to treatment outcome.</p><p>METHODS: Patients with aggressive B-cell lymphomas treated with anti-CD19 CAR T-cell therapy axicabtagene ciloleucel (axi-cel) at Skåne and Sahlgrenska University Hospitals from 2019 to October 2024 were included. CAR T-cells in peripheral blood were measured by flow cytometry. Association between maximum levels of CAR T-cells and response, progression-free survival, overall survival, cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) were investigated.</p><p>RESULTS: Peak CAR T-cell levels were higher among patients with complete response (CR) at Day 30 (p = 0.013) and at 12 months (p = 0.036). CD8+ CAR T-cells were higher in patients with CR (median 135.7, IQR 52.8-433.9) compared to patients not obtaining CR (median 23.2, IQR 11.1-103.3) (p = 0.003). The ratio of CD4+:CD8+ CAR T-cells was lower in patients obtaining CR (p = 0.046). Patients with CAR T-cells above 52.4 CAR T-cells/μL showed superior progression-free survival (p &lt; 0.001).</p><p>CONCLUSION: Our study indicates that CAR T-cell levels after axi-cel correlate to durable response, progression-free survival, and that expansion of CD8+ CAR T-cells might be of specific importance for efficacy. Potentially, CAR T-cell levels may be used to enable early detection of patients with high risk of CAR T-cell treatment failure.</p>}},
  author       = {{Werne, Louise Olsson and Elmér, Evelina and Lisak, Mikael and Pálmason, Róbert and Hult, Annika K and Dykes, Josefina and Jerkeman, Mats}},
  issn         = {{1600-0609}},
  language     = {{eng}},
  month        = {{04}},
  pages        = {{1--8}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{European Journal of Haematology}},
  title        = {{Circulating CAR T-Cells After Treatment With Axicabtagene Ciloleucel in Patients With Relapsed/Refractory Aggressive B-Cell Lymphomas and Its Association to Treatment Outcome}},
  url          = {{http://dx.doi.org/10.1111/ejh.70185}},
  doi          = {{10.1111/ejh.70185}},
  year         = {{2026}},
}