Evidence map›Paper›PMID 41530773›Full record

ArticleJournal of hematology & oncology2026

Patterns, risk factors and management of CD19-directed chimeric antigen receptor T-cell therapy failure in CNS lymphoma.

Leon D Kaulen, Philipp Karschnia, Sofia Doubrovinskaia, Jeremy S Abramson, Jacob D Soumerai, Maria Martinez-Lage, J Erika Haydu, Ganesh M Shankar, Chirayu Patel, Bryan D Choi and 9 more

Abstract readLetter
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of hematology & oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Leon D KaulenDepartment of Neurology, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA. leon.kaulen@med.uni-heidelberg.de.
Philipp KarschniaDepartment of Neurology, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
Sofia DoubrovinskaiaDepartment of Neurology and European center for Neurooncology (EZN), University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany.
Jeremy S AbramsonDepartment of Medicine, Hematology, and Oncology Division, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
Jacob D SoumeraiDepartment of Medicine, Hematology, and Oncology Division, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
Maria Martinez-LageDepartment of Pathology, Division of Neuropathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
J Erika HayduDepartment of Medicine, Hematology, and Oncology Division, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
Ganesh M ShankarDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Chirayu PatelDepartment of Radiation Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
Bryan D ChoiDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Jeffrey A BarnesDepartment of Medicine, Hematology, and Oncology Division, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
Areej El-JawahriDepartment of Medicine, Hematology, and Oncology Division, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
Ephraim P HochbergDepartment of Medicine, Hematology, and Oncology Division, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
P Connor JohnsonDepartment of Medicine, Hematology, and Oncology Division, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
Wolfgang WickDepartment of Neurology and European center for Neurooncology (EZN), University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany.
Marcela V MausDepartment of Medicine, Hematology, and Oncology Division, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
Yi-Bin ChenDepartment of Medicine, Hematology, and Oncology Division, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
Matthew J Frigault *Department of Medicine, Hematology, and Oncology Division, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
Jorg Dietrich *Department of Neurology, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA. jdietrich1@mgb.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCD19-directed chimeric antigen receptor T-cell therapy (CD19-CAR) has yielded encouraging efficacy in CNS lymphomas (CNSL), but most patients ultimately experience progressive disease (PD). Risk factors, progression patterns as well as optimal salvage therapies remain unclear.

methodsClinical and radiological characteristics of CD19-CAR failure were therefore retrospectively defined in CNSL treated at Massachusetts General Hospital from 2018 to 2024. PD patterns were defined as local or distant. CNS-progression-free survival from CD19-CAR infusion (CNS-PFS1) and first subsequent progression (CNS-PFS2) were analyzed.

resultsCD19-CAR achieved a 60% overall response rate (45% complete (CR), 15% partial response) in 60 recurrent CNSL. Median CNS-PFS1 was 4 months with radiographic PD in 36 patients (local 23.3%; local and distant 16.7%; distant 20%). PD patterns were associated with prior CD19-CAR response: Distant relapse typically occurred after CR whereas local PD followed CD19-CAR refractory disease. Peripherally contrast enhancing CNSL (pCE) at CD19-CAR infusion correlated with refractory disease. Leptomeningeal involvement (LMD) was associated with recurrence after CR. On multivariable Cox regression, pCE (Hazard ratio [HR]: 2.75; 95%-Confidence interval [CI]: 1.08-6.68, p = 0.03) and LMD (HR: 2.72; CI: 1.20-6.25, p = 0.02) were independently associated with shorter CNS-PFS1. At progression, peripheral CD19

conclusionsThis study identifies novel radiological risk factors for CD19-CAR failure in CNSL, namely pCE and LMD. Outcome in this setting is unfavorable and encouraging salvage treatments warrant prospective evaluation.

Indexed as

Antigens, CD19Central Nervous System NeoplasmsImmunotherapy, AdoptiveLymphomaReceptors, Chimeric AntigenAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsTreatment FailureAntigens, CD19CD19 molecule, humanReceptors, Chimeric AntigenChimeric antigen receptor t-cell therapyDiffuse large b-cell lymphomaImmunotherapyMagnetic resonance imagingPrimary CNS lymphomasProgression patternsSalvage therapy

Identifiers

PMID41530773
PMCPMC12801750

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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.