Demographics, disease characteristics, and recommendation decision in older adult candidates for CAR-T evaluated by the GA-MDC
| . | All patients (N = 61) . | GA-MDC recommendation . | P value . | Receipt of CAR-T therapy . | P value . | ||
|---|---|---|---|---|---|---|---|
| Proceed (n = 48) . | Decline/defer (n = 13) . | CAR-T Recipients (n = 53) . | CAR-T Nonrecipients (n = 8) . | ||||
| Age, median (range) | 73 (58-83) | 73 (65-83) | 70 (58-83) | .22 | 73 (63-83) | 72 (58-83) | .13 |
| Sex, n (%) | |||||||
| Male | 38 (62.3) | 31 (64.6) | 7 (53.8) | .53 | 31 (58.5) | 7 (87.5) | .24 |
| Female | 23 (37.7) | 17 (35.4) | 6 (46.2) | 22 (41.5) | 1 (12.5) | ||
| Diagnosis, n (%) | |||||||
| DLBCL | 36 (59.0) | 28 (58.3) | 8 (61.5) | .89 | 33 (62.3) | 3 (37.5) | .10 |
| MM | 14 (22.9) | 10 (23.0) | 4 (30.8) | 11 (20.8) | 3 (37.5) | ||
| Mantle cell lymphoma | 4 (6.6) | 4 (8.3) | 0 (0) | 4 (7.6) | 0 (0) | ||
| Follicular lymphoma | 1 (1.6) | 1 (2.1) | 0 (0) | 1 (1.9) | 0 (0) | ||
| Chronic lymphocytic lymphoma | 5 (8.2) | 4 (8.3) | 1 (7.7) | 4 (7.6) | 1 (12.5) | ||
| B-cell lymphoblastic lymphoma | 1 (1.6) | 1 (2.1) | 0 (0) | 0 (0) | 1 (12.5) | ||
| CAR-T product, n (%) | |||||||
| CD19-directed | 47 (77.0) | 38 (79.2) | 9 (69.2) | .47 | 42 (79.3) | 25 (62.5) | .36 |
| BCMA-directed | 14 (23.0) | 10 (20.8) | 4 (30.8) | 11 (20.7) | 3 (37.5) | ||
| Prior lines of therapy, median (IQR) | |||||||
| MM | 6 (4-11) | 6 (4-11) | 6 (3.5-10) | 1.00 | 5 (4-6) | 11 (10-11) | .06 |
| DLBCL | 2 (2-3) | 2 (1.5-3) | 3 (2-3.5) | .30 | 2 (2-3) | 3 (2-4) | .27 |
| R-ISS disease stage at time of GA-MDC (MM only; n = 14), n (%) | .58 | .17 | |||||
| I | 2 (14.3) | 1 (.0) | 1 (33.3) | 2 (18.2) | 0 (0) | ||
| II | 9 (64.3) | 8 (80.0) | 1 (33.3) | 8 (72.70) | 1 (33.3) | ||
| III | 1 (7.1) | 0 (0) | 1 (0) | 1 (9.1) | 0 (0) | ||
| Unknown | 2 (14.3) | 1 (10.0) | 1 (33.3) | 0 (0) | 2 (63.3) | ||
| IPI of ≥3 at time of GA-MDC (DLBCL only; n = 36), n (%) | 22 (66.7) | 18 (64.3) | 4 (80.0) | .64 | 21 (65.6) | 1 (100) | 1.00 |
| Primary refractory disease (DLBCL only; n = 36) | 14 (40.0) | 14 (50.0) | 0 (0) | .03 | 14 (43.8) | 0 (0) | 0.26 |
| Double or triple hit disease (DLBCL only; n = 36) | 11 (30.6) | 11 (39.3) | 0 (0) | .01 | 11 (33.3) | 0 (0) | 0.19 |
| LDH at lymphodepletion, median (range) | 267 (156- 926) | 273 (156- 926) | 256 (161-552) | .76 | 267 (156-926) | NA | NA |
| CRP at lymphodepletion, median (range) | 12 (3, 170) | 23 (3-170) | 9 (3-16) | .14 | 12 (3-170) | NA | NA |
| CRP <3, n (%) | 28 (52.8) | 24 (54.6) | 4 (44.4) | .72 | 28 (52.8) | 0 (0.0) | NA |
| Receipt of prior autologous stem cell transplant | 20 (32.8) | 16 (33.3) | 4 (30.8) | 1.00 | 17 (32.1) | 3 (37.5) | 1.00 |
| Stage at apheresis (NHL only; n = 40)∗ | |||||||
| I/II | 8 (20.0) | 7 (21.2) | 1 (14.3) | 1.00 | 8 (21.1) | 0 (0.0) | 1.00 |
| III/IV | 32 (80.0) | 26 (78.8) | 6 (85.7) | 30 (79.0) | 2 (100.0) | ||
| Stage at GA-MDC (NHL only; n = 42) | .66 | ||||||
| I/II | 9 (21.4) | 8 (23.5) | 1 (12.5) | 9 (23-1) | 0 (0.0) | 1.00 | |
| II/IV | 33 (78.6) | 26 (76.5) | 7 (87.5) | 30 (76.9) | 3 (100.0) | ||
| Stage at apheresis (R-ISS) (MM only; n = 14) | |||||||
| I | 2 (15.4) | 1 (10.0) | 1 (33.3) | .58 | 2 (18.2) | 0 (0.0) | .17 |
| II | 10 (76.9) | 8 (80.0) | 2 (67.7) | 9 (81.8) | 1 (50.0) | ||
| Unknown | 1 (7.7) | 1 (10.0) | 0 (0.0) | 0 (0.0) | 1 (50.0) | ||
| Days from GA-MDC until cell infusion, median (IQR) | 25 (19- 33) | 25 (19-33) | 33 (21-53) | .53 | 25 (19-33) | NA | NA |
| . | All patients (N = 61) . | GA-MDC recommendation . | P value . | Receipt of CAR-T therapy . | P value . | ||
|---|---|---|---|---|---|---|---|
| Proceed (n = 48) . | Decline/defer (n = 13) . | CAR-T Recipients (n = 53) . | CAR-T Nonrecipients (n = 8) . | ||||
| Age, median (range) | 73 (58-83) | 73 (65-83) | 70 (58-83) | .22 | 73 (63-83) | 72 (58-83) | .13 |
| Sex, n (%) | |||||||
| Male | 38 (62.3) | 31 (64.6) | 7 (53.8) | .53 | 31 (58.5) | 7 (87.5) | .24 |
| Female | 23 (37.7) | 17 (35.4) | 6 (46.2) | 22 (41.5) | 1 (12.5) | ||
| Diagnosis, n (%) | |||||||
| DLBCL | 36 (59.0) | 28 (58.3) | 8 (61.5) | .89 | 33 (62.3) | 3 (37.5) | .10 |
| MM | 14 (22.9) | 10 (23.0) | 4 (30.8) | 11 (20.8) | 3 (37.5) | ||
| Mantle cell lymphoma | 4 (6.6) | 4 (8.3) | 0 (0) | 4 (7.6) | 0 (0) | ||
| Follicular lymphoma | 1 (1.6) | 1 (2.1) | 0 (0) | 1 (1.9) | 0 (0) | ||
| Chronic lymphocytic lymphoma | 5 (8.2) | 4 (8.3) | 1 (7.7) | 4 (7.6) | 1 (12.5) | ||
| B-cell lymphoblastic lymphoma | 1 (1.6) | 1 (2.1) | 0 (0) | 0 (0) | 1 (12.5) | ||
| CAR-T product, n (%) | |||||||
| CD19-directed | 47 (77.0) | 38 (79.2) | 9 (69.2) | .47 | 42 (79.3) | 25 (62.5) | .36 |
| BCMA-directed | 14 (23.0) | 10 (20.8) | 4 (30.8) | 11 (20.7) | 3 (37.5) | ||
| Prior lines of therapy, median (IQR) | |||||||
| MM | 6 (4-11) | 6 (4-11) | 6 (3.5-10) | 1.00 | 5 (4-6) | 11 (10-11) | .06 |
| DLBCL | 2 (2-3) | 2 (1.5-3) | 3 (2-3.5) | .30 | 2 (2-3) | 3 (2-4) | .27 |
| R-ISS disease stage at time of GA-MDC (MM only; n = 14), n (%) | .58 | .17 | |||||
| I | 2 (14.3) | 1 (.0) | 1 (33.3) | 2 (18.2) | 0 (0) | ||
| II | 9 (64.3) | 8 (80.0) | 1 (33.3) | 8 (72.70) | 1 (33.3) | ||
| III | 1 (7.1) | 0 (0) | 1 (0) | 1 (9.1) | 0 (0) | ||
| Unknown | 2 (14.3) | 1 (10.0) | 1 (33.3) | 0 (0) | 2 (63.3) | ||
| IPI of ≥3 at time of GA-MDC (DLBCL only; n = 36), n (%) | 22 (66.7) | 18 (64.3) | 4 (80.0) | .64 | 21 (65.6) | 1 (100) | 1.00 |
| Primary refractory disease (DLBCL only; n = 36) | 14 (40.0) | 14 (50.0) | 0 (0) | .03 | 14 (43.8) | 0 (0) | 0.26 |
| Double or triple hit disease (DLBCL only; n = 36) | 11 (30.6) | 11 (39.3) | 0 (0) | .01 | 11 (33.3) | 0 (0) | 0.19 |
| LDH at lymphodepletion, median (range) | 267 (156- 926) | 273 (156- 926) | 256 (161-552) | .76 | 267 (156-926) | NA | NA |
| CRP at lymphodepletion, median (range) | 12 (3, 170) | 23 (3-170) | 9 (3-16) | .14 | 12 (3-170) | NA | NA |
| CRP <3, n (%) | 28 (52.8) | 24 (54.6) | 4 (44.4) | .72 | 28 (52.8) | 0 (0.0) | NA |
| Receipt of prior autologous stem cell transplant | 20 (32.8) | 16 (33.3) | 4 (30.8) | 1.00 | 17 (32.1) | 3 (37.5) | 1.00 |
| Stage at apheresis (NHL only; n = 40)∗ | |||||||
| I/II | 8 (20.0) | 7 (21.2) | 1 (14.3) | 1.00 | 8 (21.1) | 0 (0.0) | 1.00 |
| III/IV | 32 (80.0) | 26 (78.8) | 6 (85.7) | 30 (79.0) | 2 (100.0) | ||
| Stage at GA-MDC (NHL only; n = 42) | .66 | ||||||
| I/II | 9 (21.4) | 8 (23.5) | 1 (12.5) | 9 (23-1) | 0 (0.0) | 1.00 | |
| II/IV | 33 (78.6) | 26 (76.5) | 7 (87.5) | 30 (76.9) | 3 (100.0) | ||
| Stage at apheresis (R-ISS) (MM only; n = 14) | |||||||
| I | 2 (15.4) | 1 (10.0) | 1 (33.3) | .58 | 2 (18.2) | 0 (0.0) | .17 |
| II | 10 (76.9) | 8 (80.0) | 2 (67.7) | 9 (81.8) | 1 (50.0) | ||
| Unknown | 1 (7.7) | 1 (10.0) | 0 (0.0) | 0 (0.0) | 1 (50.0) | ||
| Days from GA-MDC until cell infusion, median (IQR) | 25 (19- 33) | 25 (19-33) | 33 (21-53) | .53 | 25 (19-33) | NA | NA |
Evaluations were conducted 2 to 6 weeks before tentative date of CAR-T infusion (median, 25 days).
IPI, International Prognostic Index, IQR, interquartile range; NA, not applicable; NHL, non-Hodgkin lymphoma; R-ISS, Revised International Staging System.
Two patients had missing data for staging at leukapheresis.