Wirk, Baldeep
Mayo Clinic
Massey Comprehensive Cancer Center, Institution Virginia Commonwealth University, Richmond, Virginia, USA.
Citations 2
CD19 Directed CAR T Therapy for Transformed Follicular Lymphoma: A CIBMTR Analysis
Kambhampati, Swetha , Ahn, Kwang Woo , Patel, Jinalben , Lian, Qinghua, Hertzberg, Mark P. , Metheny, Leland , Hong, Sanghee , Jain, Tania , Aljurf, Mahmoud, Vaughn, John L. , Wirk, Baldeep , Manjappa, Shivaprasad , Oliver, Carolina , Mohty, Razan , Hamadani, Mehdi, Herrera, Alex F. , Thiruvengadam, Swetha Kambhampati , Epperla, Narendranath , Jain, Tania , Iqbal, Madiha , Wirk, Baldeep , Oliver, Carolina , Shadman, Mazyar , Herrera, Alex F , Hertzberg, Mark, Epperla, Narendranath , Aljurf, Mahmoud , Beitinjaneh, Amer , Gopal, Ajay K. , Iqbal, Madiha , Shadman, Mazyar , Turtle, Cameron J. , Hamadani, Mehdi
American Journal of Hematology | August 5, 2025 | Volume: 100 | Issue: 10 | Pages: 1803-1812
ABSTRACT Transformed follicular lymphoma (tFL) is typically associated with chemotherapy resistance and a poor prognosis. There are limited data regarding outcomes after CD19‐directed chimeric antigen receptor T‐cell (CAR T) therapy in relapsed/refractory (R/R) tFL. A total of 923 adult patients with R/R tFL who received commercial CD19 CAR T therapy between 2017 and 2023 were identified in the Center for International Blood and Marrow Transplant Research registry. Median age was 64 years (range: 30–86) and median prior lines of therapy was 4 (range: 1–18). Most patients (78%) received axicabtagene ciloleucel, with 67% of patients having resistant disease at the time of CAR T infusion. At a median follow‐up of 25 months (range: 1–72) from CAR T infusion, the 2‐year overall survival (OS) was 57% (95% CI: 53–60) and progression‐free survival (PFS) was 43% (95% CI: 40–47). The 2‐year cumulative incidences of relapse or progression (rel/prog) and non‐relapse mortality (NRM) were 47% (95% CI: 44–51) and 9% (95% CI: 7–11), respectively. The overall response rate to CAR T was 76%, with a complete response rate of 63%. Grade ≥ 3 cytokine release syndrome (CRS) was observed in 7.1% and grade ≥ 3 immune effector cell–associated neurologic syndrome (ICANS) in 21.6% of patients. Multivariable analysis suggested that resistant disease status at the time of CAR T, use of bridging therapy, and high comorbidity index ≥ 3 were associated with inferior PFS and OS. Older age ≥ 60 significantly increased the risk of NRM. Our study suggests that CD19 CAR T is effective and safe for tFL.
Efficacy of Total‐Body Irradiation‐based Intensified Myeloablative Regimens for Acute Leukemia—An International Collaborative Study
Arai, Yasuyuki , Brazauskas, Ruta , He, Naya, Al‐Homsi, A. Samer, Yanada, Masamitsu , Steinberg, Amir , Hong, Sanghee , Bashey, Asad, Frangoul, Haydar , Verdonck, Leo F. , Aljurf, Mahmoud , Dias, Ajoy , Wirk, Baldeep , Freytes, César O. , Zeidan, Amer M., Lehmann, Leslie , Rangarajan, Hemalatha G. , Hashmi, Shahrukh K. , Yano, Shingo , Ozawa, Yukiyasu , Doki, Noriko, Kanda, Yoshinobu , Fukuda, Takahiro , Katayama, Yuta, Tanaka, Junji, Okamoto, Shinichiro , Saber, Wael , Yanada, Masamitsu , Kanda, Junya , Badawy, Sherif M , Sharma, Akshay , Abid, Muhammad Bilal , Wirk, Baldeep , Hashmi, Shahrukh, Kanda, Yoshinobu , Ichinohe, Tatsuo , Teshima, Takanori , Okamoto, Shinichiro , Atsuta, Yoshiko , Arai, Yasuyuki , Brazauskas, Ruta , Chhabra, Saurabh , Battiwalla, Minoo , Díaz, Miguel Ángel , Badawy, Sherif M. , Lazarus, Hillard M. , Yared, Jean A. , Hashem, Hasan , Sharma, Akshay , Abid, Muhammad Bilal , Zeidan, Amer M. , Gergis, Usama , Beitinjaneh, Amer , Askar, Medhat , Pu, Jeffrey J , Wood, William A. , Kako, Shinichi , Doki, Noriko , Katayama, Yuta
eJHaem | May 28, 2025 | Volume: 6 | Issue: 3 | Pages: No page available
ABSTRACTBackgroundIn this study, we compared outcomes of intensified myeloablative conditioning regimens using large registry data from Japan (Japanese Society for Transplantation and Cellular Therapy) and the United States (Center for International Blood and Marrow Transplant Research).MethodsAdult patients who underwent their first myeloablative allogeneic hematopoietic stem cell transplantation (HSCT) for acute leukemia in remission between 2010 and 2018 using conditioning regimens of cyclophosphamide plus total‐body irradiation (CY/TBI), CY/TBI+cytarabine (AraC), or CY/TBI+etoposide (VP16) were included.ResultsThe acute myeloid leukemia (AML) cohort (N = 480, 38.8%) indicated that overall survival (OS) was poorer in CY/TBI+AraC (hazard ratio [HR] 1.46, p < 0.001) and CY/TBI+VP16 (HR 1.39, p = 0.059) compared to CY/TBI. Relapse was not suppressed, while treatment‐related mortality (TRM) was significantly higher (HR 1.78 and 1.74, p < 0.001 and 0.018, respectively). In the acute lymphoblastic leukemia (ALL) cohort (N = 3901, 61.2%), OS was comparable among these regimens. With intensified regimens, relapse was significantly suppressed in CY/TBI+VP16 (HR 0.74, p = 0.005), while TRM was higher (HR 1.21, p = 0.077). No interactions were observed regarding the country.ConclusionIn AML adding AraC and VP16 to CY/TBI had an adverse effect on OS. Conversely, in ALL, adding VP16 or AraC to CY/TBI did not affect survival, but the addition of VP16 reduced the risk of relapse.Clinical Trial RegistrationThe authors have confirmed clinical trial registration is not needed for this submission.