Oltre le comorbilità: CAR-T come opzione sicura ed efficace nei pazienti “frail” con DLBCL in seconda linea
Abstract
CD19 CAR-T therapy is the second-line standard for relapsed/refractory DLBCL, yet the management of frail patients remains debated due to toxicity and non-relapse mortality risks. We report a 74-year-old man with high-risk DLBCL and multiple comorbidities, refractory to first-line treatment, who received axicabtagene ciloleucel. Despite high CIRS and HCT-CI scores, he only developed grade 1 CRS successfully managed with early tocilizumab and transient cytopenia, achieving durable complete remission at 14 months. This case supports evidence from ALYCANTE and real-world cohorts showing comorbidities alone do not predict severe toxicities. Instead, dynamic parameters such as ECOG, mEASIX and CAR-HEMATOTOX better identify patients at risk. A priori exclusion of frail individuals may unjustly deny access to a potentially curative therapy.
Fields of Study & Subjects
CAR-T cell therapy research
Chronic Myeloid Leukemia Treatments
Acute Lymphoblastic Leukemia research
Publication details
- Journal / source
- Recenti Progressi in Medicina
- Publisher
- Il Pensiero Scientifico Editore
- Volume
- 117
- Issue
- 2
- Pages
- e36–e39
- Publication date
- 1 February 2026
- Language
- IT