我们在基于社区的移植和细胞治疗网络登记处分析了非霍奇金淋巴瘤 (NHL) 的抗 CD19 嵌合抗原受体 T 细胞 (CART) 的获取障碍。研究期间（2018 年至 2022 年）确定了 357 名 FDA 批准的抗 CD19 CART 的预期接受者。结果显示，转诊时的中位年龄为 61 岁，转诊年份为 2018 年 (4%)、2019 年 (14%)、2020 年 (18%)、2021 年 (26%) 和 2022 年 (38%)。诊断为弥漫性大 B 细胞 (69%)、滤泡性 (13%)、滤泡性/大 (7%)、套细胞 (4%) 或其他 (7%)。输注的 CART 产品包括 Axi-cel (62%)、Tisa-cel (16%)、Brexu-cel (13%) 和 Liso-cel (9%)。 182 名患者接受了 CART 输注。转诊至咨询、咨询至血浆分离术以及采集至输注之间的中位持续时间分别为 11 天、107 天和 32 天。从咨询到 CART 输注的中位持续时间从 2019 年的 207 天稳步下降到 2022 年的 108 天。[P <0.0001] 124 名患者 (41%) 没有接受 CART，主要是因为疾病进展 (34%) 或健康状况不佳 (15%) ）。多变量逻辑回归显示，与接受 CART 的患者相比，人口、财务或社会决定因素没有显着差异。值得注意的是，不符合条件的患者比例从 2018-2020 年的 53% 下降到 2021-2022 年的 34% [P=0.001]。总之，41% 的 NHL 社区患者无法及时获得 CART 治疗，主要与疾病相关原因导致的减员有关，而总输注时间超过 4 个月。随着时间的推移，输注时间以及接受 CART 的比例有所改善。减少血浆分离术时间、早期转诊以及仔细关注挽救/桥接策略是必要的。版权所有 © 2024 美国血液学会。

We analyzed access barriers to anti-CD19+ chimeric antigen receptor T-cells (CART) for non-Hodgkin lymphoma (NHL) within a community-based transplant and cell therapy network registry. 357 intended recipients of FDA-approved anti-CD19+ CART were identified in the study period (2018 to 2022). Results showed that the median age at referral was 61 years, referral year was 2018 (4%), 2019 (14%), 2020 (18%), 2021 (26%), and 2022 (38%). Diagnoses were diffuse large B-cell (69%), follicular (13%), follicular/large (7%), mantle cell (4%), or other (7%). CART products infused were Axi-cel (62%), Tisa-cel (16%), Brexu-cel (13%) and Liso-cel (9%). 182 patients were infused with CART. The median durations between referral to consultation, consultation to apheresis, and collection to infusion were 11, 107, and 32 days, respectively. The median duration from consultation to CART infusion declined steadily from 207 days in 2019 to 108 days in 2022. [P <0.0001] 124 patients (41%) did not receive CART mostly for disease progression (34%) or poor health (15%). Multivariable logistic regression showed no significant differences in demographic, financial, or social determinants compared to those receiving CART. Notably, the proportion of ineligible patients declined from 53% in 2018-2020 to 34% by 2021-2022 [P=0.001]. In conclusion, 41% of community patients were unable to access timely CART therapy for NHL, mostly related to attrition from disease-related causes while overall time to infusion exceeded four months. Time to infusion as well as the proportion receiving CART improved over time. Reducing time to apheresis, early referral, and careful attention to salvage/bridging strategies are necessary.Copyright © 2024 American Society of Hematology.