Outcomes of Hispanic and non-Hispanic White pediatric and young adult patients with B-cell acute lymphoblastic leukemia after commercial tisagenlecleucel
Abstract/Contents
- Abstract
- Population-level data show significantly inferior outcomes for Hispanic children, adolescents, and young adults (CAYA) diagnosed with acute lymphoblastic leukemia (ALL) relative to non-Hispanic White (NHW) patients, even after adjusting for disease prognosticators and socioeconomic status. Here, we compare outcomes between Hispanic and NHW CAYA patients with relapsed and/or refractory (R/R) B-cell ALL (B-ALL) receiving tisagenlecleucel, a CD19-specific chimeric antigen receptor (CAR) T cell therapy. We used data from the Pediatric Real World CAR Consortium (PRWCC) retrospective cohort of 200 patients who underwent cell shipment to Novartis for standard-of-care tisagenlecleucel between August 2017 and March 2020 at 15 US institutions. Baseline factors, efficacy outcomes, and safety outcomes were characterized for Hispanic and NHW infused patients. With respect to baseline factors, Hispanic patients were significantly older at diagnosis and had significantly shorter time from diagnosis to infusion. Hispanic and NHW patients did not significantly differ across sex, age at CAR infusion, leukemia type, number of prior lines of therapy, receipt of prior CD19-directed therapy, disease burden pre-infusion, number of relapses pre-infusion, or initial cytogenetic risk. With respect to efficacy outcomes, Hispanic and NHW patients did not significantly differ across day 28 complete response (CR) rate, 6-month overall survival (OS), 1-year OS, 18-month OS, 6-month event-free survival (EFS), 1-year EFS, 18-month EFS, 6-month duration of response (DOR), 1-year DOR, 6-month duration of B-cell aplasia (DBA), or 1-year DBA. Univariate and multivariate analyses did not associate Hispanic ethnicity with a change in OS, EFS, DOR, or DBA. With respect to safety outcomes, Hispanic and NHW patients did not significantly differ across cytokine release syndrome (CRS), maximum CRS grade, tocilizumab use, steroid use, neurotoxicity, maximum neurotoxicity grade, grade 4 neutropenia, tumor lysis syndrome, number of infections post-infusion, or length of pediatric intensive care unit (PICU) stay. Both efficacy and safety outcomes were similar between Hispanic and NHW CAYA R/R B-ALL patients receiving tisagenlecleucel in the real-world setting. Increasing access to CAR therapy among Hispanic patients could help mitigate population-level disparities in outcomes.
Description
| Type of resource | text |
|---|---|
| Date modified | December 5, 2022 |
| Publication date | June 9, 2022; June 2022 |
Creators/Contributors
| Author | Vandris, Panayiotis |
https://orcid.org/0000-0002-4917-9019
(unverified)
|
|---|---|---|
| Thesis advisor | Kurian, Allison |
https://orcid.org/0000-0002-6175-9470
(unverified)
|
| Thesis advisor | Schultz, Liora |
https://orcid.org/0000-0001-9512-7597
(unverified)
|
Subjects
| Subject | Cellular therapy |
|---|---|
| Genre | Text |
| Genre | Thesis |
Bibliographic information
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- This work is licensed under a Creative Commons Attribution 4.0 International license (CC BY).
Preferred citation
- Preferred citation
- Vandris, P. (2022). Outcomes of Hispanic and non-Hispanic White pediatric and young adult patients with B-cell acute lymphoblastic leukemia after commercial tisagenlecleucel. Stanford Digital Repository. Available at https://purl.stanford.edu/rw109wz7229
Collection
Epidemiology & Clinical Research Masters Theses
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- pvandris@gmail.com
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