Swedish findings show promising long-term survival following CAR T-cell treatment for leukaemia and lymphoma
“The results suggest that the positive outcomes are due not only to the therapy itself but also to improved patient selection and greater knowledge in managing side effects,” says Mats Jerkeman, Senior Consultant at Skåne University Hospital and Professor at Lund University.
CAR T-cell treatment is an advanced form of personalised immunotherapy used for certain aggressive blood and lymphatic cancers, particularly in cases where few or no other treatment options exist.
“Our findings show improved treatment efficacy and fewer serious side effects compared to the very first clinical trials,” says Mats Jerkeman, lead author of the analysis in Leukemia.
The analysis includes 93 adult patients in Sweden with aggressive B-cell lymphoma (ABCL) who were treated between 2019 and 2024. Of these, 66 per cent achieved complete remission within 30 days. After one year, 53 per cent were still in remission with no signs of relapse.
“This suggests that some may be cured of their disease, although we need longer follow-up to draw firm conclusions,” says Jerkeman.
The group of patients now receiving CAR T-cell treatment had previously faced very limited treatment options, often with stem cell transplantation as the only hope. Long-term survival was rare.
“With older treatment methods, long-term survival was around 5 to 10 per cent. Now, we are seeing that over half of the patients have a chance at long-term survival. This is significantly more positive than we dared to hope when we began,” says Jerkeman.
Fewer severe side effects
CAR T-cell therapy can cause serious side effects, including cytokine release syndrome (CRS), a sepsis-like reaction, and ICANS, a condition involving neurological symptoms. However, the Swedish study shows markedly lower rates of severe complications than earlier clinical trials.
“Only one per cent of patients experienced severe CRS, and ICANS occurred at roughly half the frequency reported in initial studies. This indicates both better patient selection and greater experience in managing side effects,” says Jerkeman.
Older patients responding well
A particularly interesting finding is that older patients did not have worse outcomes than younger ones. On the contrary, there was a trend towards better survival among patients over the age of 70.
“It appears that age alone is not a decisive factor in prognosis. This may be because we were especially careful in selecting older patients, but the results show that even people in older age groups can benefit greatly from CAR T-cell treatment,” says Mats Jerkeman.
The analysis also showed that stronger ICANS symptoms may be linked to better long-term survival, a finding that Mats Jerkeman says should be explored further in future studies.
Now standard treatment in Sweden
CAR T-cell treatment is now established as the standard of care for difficult-to-treat ABCL and pre-B acute lymphoblastic leukaemia (pre-B-ALL) in Sweden. All patients are discussed at national conferences, and the treatment is now available at all Swedish university hospitals.
In short: CAR T-cell treatment
- CAR T-cell therapy is a treatment in which T-cells are extracted from the patient and sent to a laboratory.
- There, the T-cells are modified into aggressive cells that, when reintroduced into the body, attack a specific protein on the cancer cells.
- After approximately six weeks, the patient undergoes a PET-CT scan to determine whether the treatment has been effective.
- Currently, six different CAR T-cell therapies have been approved by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Three of these are recommended for use in Sweden by the New Therapies (NT) Council.