A Single-Arm Clinical Study of CD19 CAR-T Following ASCT for Relapsed/Refractory B-Cell Non-Hodgkin's Lymphoma (R/R B-NHL) With High-Risk Prognostic Factors
Clinical trial for the safety and efficacy of CD19 CAR-T following autologous hematopoietic stem cell transplantation (ASCT) for Relapsed/Refractory B-Cell Non-Hodgkin's Lymphoma (R/R B-NHL) with High-Risk Prognostic Factors
• Histologically confirmed B-cell non-Hodgkin's lymphoma including the following types
‣ diffuse large B-cell lymphoma
⁃ high-grade B-cell lymphoma with or without MYC and BLC2 and/or BCL6 rearrangement
⁃ transformed lymphoma
⁃ primary mediastinal large B-cell lymphoma
⁃ follicular lymphoma (FL)
• Relapsed or refractory diseases fulfilling one of the following criteria (individuals must have received anti-CD20 monoclonal antibody and anthracycline-containing chemotherapy regimen)
‣ Primary refractory disease, defined as disease progression after first-line immunochemotherapy or disease progression within 6 weeks of the end of the last chemotherapy
⁃ Stable disease (SD) as best response after at least 4 cycles of first-line therapy
⁃ Partial response (PR) as best response after at least 6 cycles of first-line therapy (biopsy-proven residual disease is needed for individuals with Deauville score of 4)
⁃ PR as best response after at least 2 cycles of second-line therapy
⁃ Disease relapse ≤12 months after the completion of first-line immunochemotherapy
⁃ Relapsed or refractory disease after ≥2 lines of chemotherapy
• Presence of at least one of the following high-risk prognostic factors: (1) extranodal involvement; (2) maximum diameter of the bulky mass ≥5 cm; (3) TP53 gene alterations
• Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
• Eligible for HDCT/ASCT based on the investigator's assessment and are scheduled to undergo an ASCT sequential CAR-T treatment regimen
• Adequate renal and hepatic function defined as:
‣ Serum alanine aminotransferase (ALT/AST) ≤ 3 upper limit of normal (ULN)
⁃ Total bilirubin ≤1.5 mg/dL(\<3 times ULN in patients with Gilbert's syndrome, cholestasis due to hepatoportal compression adenopathy, biliary obstruction in patients with liver involvement or lymphoma)
⁃ Serum creatinine ≤1.5 ULN, or creatinine clearance (as estimated by Cockcroft Gault) ≥ 30 mL/min
• Cardiac ejection fraction ≥ 40%
• Baseline oxygen saturation \> 95% on room air
• Life expectancy ≥3 months