PRESENTED at EBMT 2025 Annual Meeting, this study investigated the role of functional respiratory tests (FRT) in screening patients before anti-CD19 CAR-T cell therapy, focusing on their impact on outcomes such as non-relapse mortality (NRM), overall survival (OS), and progression-free survival (PFS). This abstract was recognised as one of the ‘Best Young Abstract Awards’ for outstanding poster presentations.
FRTs, commonly used in allogeneic stem cell transplantation, are routinely included in pre-treatment evaluations, but their relevance for CAR-T cell therapy has been less explored. The retrospective, multicentre observational study, enrolled 68 patients with aggressive B-cell non-Hodgkin lymphomas receiving CAR-T cell therapy between April 2019 and November 2024, assessed various FRT parameters, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, and diffusing capacity of the lungs for carbon monoxide (DLCO).
The median time between functional respiratory test (FRT) and infusion was 48.5 days. With a median follow-up of 17.6 months, the 1-year cumulative incidence of non-relapse mortality (NRM) was 13.4%, with one-year progression-free survival (PFS) and overall survival (OS) at 48.0% and 57.7%, respectively. The 1-year cumulative incidence of relapse (CIR) was 38.6%. Patients with forced vital capacity (FVC) ≤87% had higher NRM, lower OS, and lower PFS. FVC ≤87% remained significantly associated with higher NRM in multivariate analysis (HR=10.2; 95%CI: 1.5-66.8; p=0.016).
This research highlights the potential value of FRT in pre-treatment screening, suggesting that FVC could be a critical factor in predicting outcomes for CAR-T cell therapy candidates. Further studies are needed to confirm these findings and refine screening protocols.
Reference
Losi G et al. Abstract: A083. Presented at EBMT 2025 Annual Meeting; 31 Mar -2 April; Florence, Italy.
