CD8 and CD4 CAR-T cells are associated with outcome and toxicity of tisagenlecleucel in central nervous system lymphoma.

Abstract

CAR-T cells have been proposed as a new treatment option for primary and secondary central nervous system lymphoma (CNSL). However, whether CAR-T cell features contribute to response and toxicity in CNSL remains elusive. Twenty-four patients with primary and secondary CNSL treated with tisagenlecleucel were retrospectively included in this study. CAR-T cells were analysed in infusion products, blood ans cerebrospinal fluid using flow cytometry. Here, we show that robust expansion of CD8⁺ CAR-T cells was associated with early response and better long-term survival. Additionally, CD4⁺ CAR-T cells appeared to play a pivotal role in the development of cytokine release syndrome. These data represent the first evidence of these mechanisms in CNSL patients and emphasize the relevance of CAR-T cell phenotype monitoring to predict efficacy and toxicity.