Predicting CAR-T outcomes in R/R DLBCL: a multicenter real-world study of a 5-index model
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By
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Bin Xue
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Huina Lu
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Yifan Liu
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Ying Lu
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Wenjun Zhang
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Bing Xiu
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Xiu Luo
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Li Wang
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Wenbin Qian
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Aibin Liang
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Ping Li
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June 16, 2026
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Clinical Scorecard: Forecasting Outcomes of CAR-T Therapy in Relapsed/Refractory DLBCL: A Multicenter Real-World Validation of a Five-Index Model
At a Glance
| Category | Detail |
|---|
| Condition | Relapsed/Refractory Diffuse Large B-Cell Lymphoma (R/R DLBCL) |
| Key Mechanisms | Chimeric Antigen Receptor T-Cell Therapy (CAR-T) |
| Target Population | Chinese patients with R/R DLBCL |
| Care Setting | Multicenter real-world study |
Key Highlights
- 5-index prediction model incorporates DEL status, TP53 alterations, ECOG performance status, bulky disease, and prior therapy lines.
- C-index for the model was 0.767, indicating good predictive performance.
- Significant differences in PFS and OS observed across risk groups (P < 0.0001 for PFS; P = 0.0007 for OS).
- Model outperformed traditional prognostic indices like IPI and R-IPI.
- Study included 92 patients across four Chinese centers.
Guideline-Based Recommendations
Diagnosis
- Diagnosis based on pathological evaluation according to the 2016 WHO classification.
Management
- Utilization of CD19 CAR-T therapy based on the 5-index model for predicting treatment outcomes.
Monitoring & Follow-up
- Follow-up for overall response rate, complete response rate, progression-free survival, and overall survival.
Risks
- 40-60% of patients may fail to attain durable remission despite CAR-T therapy.
Patient & Prescribing Data
92 patients with R/R DLBCL from four Chinese centers.
Axi-cel and Relma-cel were the primary CAR-T products used.
Clinical Best Practices
- Incorporate molecular features such as TP53 alterations and DEL status in treatment planning.
- Utilize the 5-index model for personalized treatment decisions.
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