{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T05:02:04Z","timestamp":1777006924057,"version":"3.51.4"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Tisagenlecleucel (Tisa-cel), approved by the Korean Ministry of Food and Drug Safety (MFDS) in 2021 and reimbursed since April 2022, is currently the only second-generation chimeric antigen receptor (CAR) T-cell therapy available in Korea. This study aimed to evaluate the real-world efficacy, safety, logistics, and outcomes of Tisa-cel in Korean patients with relapsed or refractory diffuse large B-cell lymphoma (R\/R DLBCL) and identify prognostic factors associated with survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 79 patients with R\/R DLBCL who received Tisa-cel at the Catholic Hematology Hospital between April 2022 and January 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median decision-to-infusion and vein-to-vein times were 49 and 40 days, respectively. Bridging chemotherapy was administered to 64 patients, with an overall response rate (ORR) of 40.6% and a complete response (CR) rate of 14.1% before infusion. Three months after Tisa-cel treatment, the ORR and CR rates were 72.9% and 64.4%, respectively. Tisa-cel was administered as third-line therapy in 50.6% of the patients, and 48.1% had refractory disease. Of the patients who experienced relapse (43%), approximately half transitioned to palliative care, 8.8% were enrolled in clinical trials, and 5.9% proceeded to allogeneic transplantation. Non-relapse mortality was 11.7%, primarily due to infections (n\u00a0= 7) and immune effector cell\u2013associated neurotoxicity syndrome (ICANS)-related events (n = 2). Cytokine release syndrome occurred in 70.9% of patients (grade \u2265 3 in 22.8%) and ICANS in 21.5% (grade \u2265 3 in 8.8%), with a median onset at 2 and 5 days, respectively. Tocilizumab and dexamethasone were used in 45.6% and 13.9% of the patients, respectively. With a median follow-up of 11.6 months, the median progression-free survival was 4.9 months, and the median overall survival was 21.6 months. Achieving CR at 3 months was strongly associated with superior survival (p &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Tisa-cel demonstrated favorable efficacy and manageable safety in Korean patients with R\/R DLBCL. Early CR strongly predicted long-term outcomes, whereas ICANS occurrence and steroid use were associated with poorer prognosis, underscoring the need to optimize toxicity management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1823568","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T04:29:59Z","timestamp":1777004999000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world clinical outcomes of tisagenlecleucel in relapsed or refractory diffuse large B-cell lymphoma: a single-center retrospective study"],"prefix":"10.3389","volume":"16","author":[{"given":"Gi-June","family":"Min","sequence":"first","affiliation":[{"name":"Department of Hematology, Seoul St. Mary\u2019s Hematology Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tong Yoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Hematology, Yeouido St. Mary\u2019s Hematology Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young-Woo","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Hematology, Yeouido St. Mary\u2019s Hematology Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung Soo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Hematology, Seoul St. Mary\u2019s Hematology Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Hematology, Seoul St. Mary\u2019s Hematology Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae-Ho","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Hematology, Seoul St. Mary\u2019s Hematology Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung-Eun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Hematology, Seoul St. Mary\u2019s Hematology Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byung Sik","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Hematology, Seoul St. Mary\u2019s Hematology Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoo-Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Hematology, Seoul St. Mary\u2019s Hematology Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ki-Seong","family":"Eom","sequence":"additional","affiliation":[{"name":"Department of Hematology, Seoul St. Mary\u2019s Hematology Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hee-Je","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Hematology, Seoul St. Mary\u2019s Hematology Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang-Ki","family":"Min","sequence":"additional","affiliation":[{"name":"Department of Hematology, Seoul St. Mary\u2019s Hematology Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seok-Goo","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Hematology, Seoul St. Mary\u2019s Hematology Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-03-769620","article-title":"Outcomes in refractory diffuse large B-cell lymphoma: results from the international SCHOLAR-1 study","volume":"130","author":"Crump","year":"2017","journal-title":"Blood"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2022.008","article-title":"Outcomes in refractory diffuse large B-cell lymphoma: results from two prospective Korean cohorts","volume":"55","author":"Yi","year":"2023","journal-title":"Cancer Res Treat"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31366-0","article-title":"Lisocabtagene maraleucel for patients with relapsed or refractory large B-cell lymphomas (Transcend NHL 001): a multicentre seamless design study","volume":"396","author":"Abramson","year":"2020","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/S1470-2045(18)30864-7","article-title":"Long-term safety and activity of axicabtagene ciloleucel in refractory large B-cell lymphoma (ZUMA-1): a single-arm, multicentre, phase 1\u20132 trial","volume":"20","author":"Locke","year":"2019","journal-title":"Lancet Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707447","article-title":"Axicabtagene ciloleucel CAR T-cell therapy in refractory large B-cell lymphoma","volume":"377","author":"Neelapu","year":"2017","journal-title":"N Engl J Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1056\/NEJMoa1804980","article-title":"Tisagenlecleucel in adult relapsed or refractory diffuse large B-cell lymphoma","volume":"380","author":"Schuster","year":"2019","journal-title":"N Engl J Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2023020197","article-title":"Real-world experience of CAR T-cell therapy in older patients with relapsed\/refractory diffuse large B-cell lymphoma","volume":"142","author":"Chihara","year":"2023","journal-title":"Blood"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-023-02334-w","article-title":"Safety and efficacy of tisagenlecleucel in patients with relapsed or refractory B-cell lymphoma: the first real-world evidence in Japan","volume":"28","author":"Goto","year":"2023","journal-title":"Int J Clin Oncol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"77.e1","DOI":"10.1016\/j.jtct.2023.10.017","article-title":"Real-world outcomes with chimeric antigen receptor T cell therapies in large B cell lymphoma: A systematic review and meta-analysis","volume":"30","author":"Jacobson","year":"2024","journal-title":"Transplant Cell Ther"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15184671","article-title":"Outcomes of chimeric antigen receptor (CAR) T-cell therapy in patients with large B-cell lymphoma (LBCL): a single-institution experience","volume":"15","author":"Trando","year":"2023","journal-title":"Cancers (Basel)"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2023.0057","article-title":"NCCN Guidelines\u00ae insights: B-cell lymphomas, version 6.2023","volume":"21","author":"Zelenetz","year":"2023","journal-title":"J Natl Compr Canc Netw"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(21)00375-2","article-title":"Long-term clinical outcomes of tisagenlecleucel in patients with relapsed or refractory aggressive B-cell lymphomas (JULIET): a multicentre, open-label, single-arm, phase 2 study","volume":"22","author":"Schuster","year":"2021","journal-title":"Lancet Oncol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-025-04006-z","article-title":"Clinical outcomes of tisagenlecleucel in relapsed\/refractory diffuse large B-cell lymphoma: insights from a single-center study","volume":"122","author":"Yoon","year":"2025","journal-title":"Int J Hematol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01620-2","article-title":"The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: lymphoid Neoplasms","volume":"36","author":"Alaggio","year":"2022","journal-title":"Leukemia"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.12.758","article-title":"ASTCT consensus grading for cytokine release syndrome and neurologic toxicity associated with immune effector cells","volume":"25","author":"Lee","year":"2019","journal-title":"Biol Blood Marrow Transplant"},{"key":"B16","article-title":"Common terminology criteria for adverse events (CTCAE). v5.0","volume-title":"United States Department of Health and Human Services, National Institutes of Health \u2013 National Cancer Institute","year":"2017"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2013.54.8800","article-title":"Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification","volume":"32","author":"Cheson","year":"2014","journal-title":"J Clin Oncol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2024-009890","article-title":"Real-world outcomes with tisagenlecleucel in aggressive B-cell lymphoma: subgroup analyses from the CIBMTR registry","volume":"13","author":"Landsburg","year":"2025","journal-title":"J Immunother Cancer"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2021006193","article-title":"Long-term safety for patients with tisagenlecleucel-treated relapsed\/refractory diffuse large B-cell lymphoma","volume":"6","author":"Jaeger","year":"2022","journal-title":"Blood Adv"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2030164","article-title":"Five-year outcomes for refractory B-cell lymphomas with CAR T-cell therapy","volume":"384","author":"Chong","year":"2021","journal-title":"N Engl J Med"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2024.10.021","article-title":"Association of CD19+-targeted chimeric antigen receptor (CAR) T-cell therapy with hypogammaglobulinemia, infection, and mortality","volume":"155","author":"Sutherland","year":"2025","journal-title":"J Allergy Clin Immunol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-023-00754-1","article-title":"Long-term outcomes following CAR T cell therapy: what we know so far","volume":"20","author":"Cappell","year":"2023","journal-title":"Nat Rev Clin Oncol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2023.04.007","article-title":"Mechanisms of resistance and treatment of relapse after CAR T-cell therapy for large B-cell lymphoma and multiple myeloma","volume":"29","author":"Rejeski","year":"2023","journal-title":"Transplant Cell Ther"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.21037\/tcr-23-1396","article-title":"A STEP ahead for CAR-T cell therapy of large B cell lymphoma: understanding the molecular determinants of resistance","volume":"12","author":"Mouhssine","year":"2023","journal-title":"Transl Cancer Res"},{"key":"B25","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1182\/bloodadvances.2025016727","article-title":"Late failure of aggressive B-cell lymphoma after CAR T-cell therapy: a LYSA study from the DESCAR-T registry","volume":"10","author":"Erbella","year":"2026","journal-title":"Blood Adv"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01739-2","article-title":"Outcomes of first therapy after CD19-CAR-T treatment failure in large B-cell lymphoma","volume":"37","author":"Alarcon Tomas","year":"2023","journal-title":"Leukemia"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2025016968","article-title":"Outcomes of bispecific antibodies after CAR T-cell failure for large B-cell lymphoma: results from the ABC consortium","volume":"10","author":"Melody","year":"2026","journal-title":"Blood Adv"},{"key":"B28","doi-asserted-by":"publisher","first-page":"98","DOI":"10.3324\/haematol.2022.281242","article-title":"Allogeneic transplant following CAR T-cell therapy for large B-cell lymphoma","volume":"108","author":"Zurko","year":"2023","journal-title":"Haematologica"},{"key":"B29","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1182\/blood.2019000017","article-title":"Efficacy and safety of CAR19\/22 T-cell cocktail therapy in patients with refractory\/relapsed B-cell Malignancies","volume":"135","author":"Wang","year":"2020","journal-title":"Blood"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2025016375","article-title":"An AI model classifies risks of early relapse post\u2013CAR T-cell therapy in a multicenter real-world population with DLBCL","volume":"9","author":"Wang","year":"2025","journal-title":"Blood Adv"},{"key":"B31","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1186\/s12967-025-07646-1","article-title":"Immune effector cell-associated neurotoxicity syndrome following CAR T-cell therapy: a review of recent advances","volume":"24","author":"Fatahichegeni","year":"2025","journal-title":"J Transl Med"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1823568\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T04:30:00Z","timestamp":1777005000000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1823568\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,24]]},"references-count":31,"alternative-id":["10.3389\/fonc.2026.1823568"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1823568","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,24]]},"article-number":"1823568"}}