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GVHD and NRM After CAR-T and Allo-HCT

Othman T, Yang D, Shouse G, et al. Impact of Prior Chimeric Antigen Receptor T-Cell Treatment on Graft-Versus-Host Disease and Nonrelapse Mortality After Allogeneic Transplantation. Transplantation and Cellular Therapy. 2026; (doi: 10.1016/j.jtct.2026.06.052).

Graft-versus-host disease (GVHD) and non-relapse mortality (NRM) are possible after allogeneic hematopoietic cell transplantation (allo-HCT), but researchers say a recipient's pre-procedure history of chimeric antigen receptor (CAR) T-cell therapy has no bearing on risk. The retrospective case-control study documented outcomes in 65 adults undergoing a first transplant after previous CAR-T treatment and compared them with those of 116 similar patients who did not receive the immunotherapy before transplant. There was no evidence of an increased risk of either NRM or acute or chronic GVHD in the group with prior CAR-T exposure. The rate of day-100 NRM was 6.2% in the case patients vs. 8.6% in the controls, and the day-100 cumulative incidence of GVHD was 43.1% vs. 44.8%, respectively, for grade 2-4 disease and 20.0% vs. 12.1%, respectively, for grade 3-4 acute GVHD. While these differences were not statistically meaningful, investigators did observe improved graft-versus-host disease/relapse-free survival in patients who received their transplant within 3 months of undergoing CAR-T therapy.

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