Researchers from Fox Chase Cancer Center and Temple Health have found that measuring lymphocyte levels in the blood can help predict outcomes for non-Hodgkin lymphoma patients treated with CAR T-cell therapy. The findings were presented at the 67th American Society of Hematology (ASH) Annual Meeting and Exposition.
The study showed that a higher absolute lymphocyte count (ALC) and a faster increase in ALC after treatment are associated with better results, such as longer progression-free survival, overall survival, and complete response rates. A high concentration of lymphocytes suggests a strong immune response.
"It makes sense that patients showing robust immune responses are the ones having better progression free survival and better overall survival," said Gandler, who conducted the research under the mentorship of Anthony Stack, DO, Assistant Professor at the Blood Cancer and Cellular Therapy Institute at Fox Chase and senior author on the study.
CAR T-cell therapy involves collecting a patient's T cells, genetically modifying them to target lymphoma cells, and infusing them back into the patient. This treatment is relatively new for non-Hodgkin lymphoma (NHL), especially for cases where previous treatments have failed or the disease has relapsed. While CAR T-cell therapy is often effective initially, many patients eventually relapse. Identifying those likely to relapse early could help doctors adjust treatment plans sooner.
For this research, scientists examined how ALC relates to outcomes in NHL patients who received axicabtagene ciloleucel (Yescarta), a type of CAR T therapy. According to Gandler, this is the first time that an increasing rate of ALC has been recognized as a possible marker for treatment response.
"It's especially exciting because checking a patient's ALC can be done with existing hospital resources and at relatively low cost," she added.
This study is part of ongoing work led by Stack to understand CAR T-cell therapy's effectiveness across different patient groups. Researchers plan to investigate whether similar trends appear in patients receiving other forms of CAR T-cell therapy like lisocabtagene maraleucel.
