CAR T shows decade-long disease control in B-cell lymphoma

Clinical takeaway: Ten-year follow-up strengthens the evidence that CD19-directed CAR T-cell therapy can produce long-lasting, potentially curative remissions in some patients with relapsed or refractory B-cell lymphoma. Long-term survivors still need structured follow-up for relapse, immune recovery, infections, cytopenias, and new primary cancers.

A single infusion of CD19-directed CAR T-cell therapy produced decade-long lymphoma-free remissions in some patients with relapsed or refractory B-cell non-Hodgkin lymphoma, according to long-term follow-up data published in The New England Journal of Medicine.

The study provides rare 10-year outcome data for CAR T-cell therapy, which is now standard treatment for several relapsed or refractory B-cell lymphomas but has had limited long-term follow-up. The findings help clarify both the curative potential of this approach and the late risks clinicians should consider as more patients live years after treatment.

Researchers evaluated 38 patients with relapsed or refractory B-cell non-Hodgkin lymphoma who had received multiple prior therapies before a single infusion of CTL019, now known as tisagenlecleucel. The cohort included 24 patients with large B-cell lymphoma and 14 with follicular lymphoma. Median follow-up was 10.1 years.

All relapses occurred within 5.4 years of infusion. Among patients who remained lymphoma-free after that point, remissions appeared durable through 10 years of follow-up. In this small cohort, a single infusion produced decade-long lymphoma-free survival in about one third of patients with large B-cell lymphoma and nearly half of those with follicular lymphoma.

Late outcomes were shaped not only by lymphoma control, but also by survivorship issues. Persistent grade two or three neutropenia occurred in two patients, and no late anemia or thrombocytopenia was observed. Nine patients developed a new primary cancer during follow-up. Deaths unrelated to lymphoma relapse also occurred, underscoring the importance of follow-up beyond disease surveillance.

Among patients with long-term response, B-cell aplasia persisted in 44%, and higher CAR-transgene persistence appeared to be associated with long-term response. The findings suggest that continued CAR T-cell activity may help explain durable remission, while also requiring attention to immune recovery and infection risk.

For clinicians, the results reinforce that CAR T therapy can produce long treatment-free remissions in a subset of patients with otherwise difficult-to-treat B-cell lymphomas. The data also point to the need for survivorship care that extends well beyond the early toxicity window, including monitoring for relapse, cytopenias, immune dysfunction, infections, new primary cancers, and late non-relapse complications.

Source: Ruella M, et al. 2026 June 24. N Engl J Med. Ten-year outcomes after CAR T-cell therapy for B-cell lymphomas