Efficacy and Safety of CAR T-Cell Therapy in Primary Central Nervous System Lymphoma: A Systematic Review and Meta-Analysis

Abdulrahman F. Al-Mashdalia; Mujahid O. Abdelraofb; Rasha Kaddourac; Azza M. Halfawid; Mohamed Elfatih M. Yousife; Mohammed Abdulgayooma; Mahmood Aldaptf; Abdul Rashid Shah a; Shehab F. Mohameda

aHematology and Bone Marrow Transplant, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar · bPublic and Environmental Health, Gezira University, Wad Madani, Sudan · c Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar dNational Ribat University, Khartoum, Sudan · eUniversity of Khartoum, Sudan · fHematology and Medical Oncology, Mayo Clinic, Jacksonville, Florida, USA

INTRODUCTION

PCNSL is a rare, aggressive B-cell lymphoma. Half of patients relapse within two years. 15–20% are refractory to first-line therapy. 1 Median survival after relapse is 4–12 months. 2,4 CNS disease was excluded from every pivotal CAR-T trial, on fear of neurotoxicity. 3 Most reviews mix primary and secondary CNS lymphoma, so disease-specific estimates are missing.

AIM

Pool all published outcomes of CAR-T therapy in PCNSL. Endpoints: overall, complete and partial response; overall and progression-free survival at 6 and 12 months; cytokine release syndrome, ICANS and treatment-related mortality.

METHODS

Design: systematic review and meta-analysis. Search: PubMed, Scopus, Web of Science, inception to February 2026. Eligible: studies reporting clinical outcomes of CAR-T in PCNSL. Yield: 23 reports. 15 studies pooled (n = 194). 8 reports described qualitatively (n = 9). Model: random effects, with I² for heterogeneity.

RESULTS

See the Figures in the poster..

CONCLUSIONS

CAR-T showed activity in PCNSL. Two in three patients respond to treatment, and most responses are complete. Toxicity is manageable. Severe CRS and severe ICANS stay near systemic-lymphoma levels. Durability is the gap. Survival falls between 6 and 12 months. Disease-specific prospective trials are needed.