ArticleBlood advances2024
Bendamustine lymphodepletion before axicabtagene ciloleucel is safe and associates with reduced inflammatory cytokines.
Article in Blood advances, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Bendamustine-based lymphodepletion prior to CAR T-cell therapy: a systematic review.Bone marrow transplantation · 2026Pooled it
- Neuropsychiatric manifestations following chimeric antigen receptor T cell therapy for cancer: a systematic review of clinical outcomes and management strategies.Journal for immunotherapy of cancer · 2024Pooled it
- Impact of prior CAR T-cell therapy on mosunetuzumab efficacy in patients with relapsed or refractory B-cell lymphomas.Blood advances · 2025Trial
- Polatuzumab vedotin-containing regimens as bridge to CART: analysis from the CART-SIE study.Blood advances · 2026Observational
- Comparison of Fludarabine Versus Bendamustine as a Lymphodepleting Chemotherapy Prior to CAR-T for Large Cell Lymphoma.Transplantation and cellular therapy · 2026Article
- Real-world outcomes and toxicities of CAR-T in relapsed/refractory follicular lymphoma: a multicenter cohort study.Blood advances · 2026Article
- Naïve CD4Nature communications · 2026Article
- HosTIL territory: mapping the landscape of toxicity in TIL therapy.Journal for immunotherapy of cancer · 2026Review
- CD4Nature medicine · 2026Article
- Can we cure autoimmunity?Current opinion in immunology · 2026Review
- The impact of the large B-cell lymphoma tumor microenvironment on efficacy of CD19-directed CAR-T immunotherapy.Frontiers in immunology · 2026Review
- Predictors of response to CD19 chimeric antigen receptor T-cell therapy in large B-cell lymphoma: a consolidated review.Current opinion in oncology · 2025Review
- Bridging intensity is associated with impaired hematopoietic recovery after BCMA CAR-T therapy for multiple myeloma.Blood advances · 2025Observational
- Noncanonical and mortality-defining toxicities of CAR T cell therapy.Nature medicine · 2025Review
- SITC vision: Opportunities for deeper understanding of mechanisms of anti-tumor activity, toxicity, and resistance to optimize cancer immunotherapy.Journal for immunotherapy of cancer · 2025Article
- Immune effector cell-associated hematotoxicity: mechanisms, clinical manifestations, and management strategies.Haematologica · 2025Review
- Lymphodepletion chemotherapy in chimeric antigen receptor-engineered T (CAR-T) cell therapy in lymphoma.Bone marrow transplantation · 2025Review
- Review
- Diverse potential of chimeric antigen receptor-engineered cell therapy: Beyond cancer.Clinical and translational medicine · 2025Review
- Combined in silico/in vitro approaches for identifying modulators of the activity of the p.Tyr110Cys Carnitine O-Acetyltransferase (CRAT) variant associated to an early onset case of Leigh syndrome.Acta pharmacologica Sinica · 2025Article
Corrections and comments
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Authors and funding
29 authors at 2 institutions in 2 countries.
Funding
Abstract
abstractLymphodepletion (LD) is an integral component of chimeric antigen receptor T-cell (CART) immunotherapies. In this study, we compared the safety and efficacy of bendamustine (Benda) to standard fludarabine/cyclophosphamide (Flu/Cy) LD before CD19-directed, CD28-costimulated CART axicabtagene ciloleucel (axi-cel) for patients with large B-cell lymphoma (LBCL) and follicular lymphoma (FL). We analyzed 59 patients diagnosed with LBCL (n = 48) and FL (n = 11) consecutively treated with axi-cel at the University of Pennsylvania. We also analyzed serum samples for cytokine levels and metabolomic changes before and after LD. Flu/Cy and Benda demonstrated similar efficacy, with complete remission rates of 51.4% and 50.0% (P = .981), respectively, and similar progression-free and overall survivals. Any-grade cytokine-release syndrome occurred in 91.9% of patients receiving Flu/Cy vs 72.7% of patients receiving Benda (P = .048); any-grade neurotoxicity after Flu/Cy occurred in 45.9% of patients and after Benda in 18.2% of patients (P = .031). In addition, Flu/Cy was associated with a higher incidence of grade ≥3 neutropenia (100% vs 54.5%; P < .001), infections (78.4% vs 27.3%; P < .001), and neutropenic fever (78.4% vs 13.6%; P < .001). These results were confirmed both in patients with LBCL and those with FL. Mechanistically, patients with Flu/Cy had a greater increase in inflammatory cytokines associated with neurotoxicity and reduced levels of metabolites critical for redox balance and biosynthesis. This study suggests that Benda LD may be a safe alternative to Flu/Cy for CD28-based CART CD19-directed immunotherapy with similar efficacy and reduced toxicities. Benda is associated with reduced levels of inflammatory cytokines and increased anabolic metabolites.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.