Dr Kamdar on Patient Monitoring After Liso-Cel in MCL and Hematologic Malignancies

“[These results] call for some rethinking around the mandated 4-week requirement for patients to be [present at the] treating site. Hopefully, this will allow for personalized tailoring of [patient] monitoring requirements after liso-cel infusion.”

Manali Kamdar, MD, the clinical director of Lymphoma Services and an associate professor of Medicine-Hematology at the University of Colorado Anschutz Medical Campus, discussed findings from an analysis of the timing of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) onset, grade, and resolution in patients with mantle cell lymphoma (MCL) and other hematologic malignancies who were treated with lisocabtagene maraleucel (liso-cel; Breyanzi).

The analysis, data from which was presented during the 2025 ASCO Annual Meeting, included patients with relapsed/refractory MCL, large B-cell lymphoma (LBCL), chronic lymphocytic leukemia/small lymphocytic lymphoma, and follicular lymphoma treated in the pivotal phase 1 TRANSCEND-NHL-001 (NCT02631044), phase 1/2 TRANSCEND CLL 004 (NCT03331198), phase 3 TRANSFORM (NCT03575351), phase 2 TRANSCEND-PILOT (NCT03483103), and phase 2 TRANSCEND FL (NCT04245839) trials. The analysis also included real-world data from patients with relapsed/refractory LBCL who were treated with liso-cel from The Center for International Blood and Marrow Transplant Research (CIBMTR) registry.

Findings from the analysis revealed that patients in the clinical trials cohort (n = 702) experienced any-grade CRS at a rate of 54%, Kamdar began. Ninety-eight percent of these events were reported within the first 15 days following liso-cel infusion, she noted. Similarly, patients in the CIBMTR registry (n = 877) experienced any-grade CRS at a rate of 49%, and 97% of CRS events occurred within the first 15 days after treatment, Kamdar said. Late-onset CRS was rare and was low-grade and manageable when it did occur, she noted.

In terms of ICANS, 31% of patients experienced an any-grade event in the clinical trials cohort and 88% of events occurred within the first 15 days post infusion, Kamdar said. In the CIMBTR dataset, these respective rates were 27% and 95%, she added.

These findings should cause investigators to reconsider the mandated 4-week requirement for patients who receive liso-cel to be near the treating site, Kamdar explained. In the future, personalized monitoring requirements will hopefully be developed in order to improve access to the treatment, she concluded.