An immune-cell treatment makes a measurable difference for older lymphoma patients

Oncology and later-life care · Source date: November 2026 journal issue; indexed by November 2 · Evidence: Multicenter, open-label, randomized phase 2 trial · Primary source

Older adults with relapsed large B-cell lymphoma may be too medically vulnerable for transplantation. In that setting, therapies need to be judged by what happens after treatment, including the chance of serious toxicity. The DALY 2-EU trial tested a dual CD20/CD19-directed CAR T-cell product, zamtocabtagene autoleucel, against rituximab, gemcitabine and oxaliplatin chemotherapy in patients deemed ineligible for transplant. The median age was 74.

Across 160 randomized patients at 45 European centers, independently assessed median event-free survival was 6.21 months with CAR T treatment and 2.53 months with chemotherapy (hazard ratio 0.39; 95% CI 0.27–0.58). Serious adverse events were reported in 41% and 66%, respectively, among treated participants. Grade 3 or higher adverse events remained common in both arms (83% and 86%). CAR T treatment caused two treatment-related deaths, including cytokine-release syndrome and hemophagocytic lymphohistiocytosis; one treatment-related death occurred in the control arm.

This is promising evidence in older patients who could not undergo transplantation. Follow-up was relatively short. Manufacturing time, monitoring and caregiver support matter, and the trial does not establish regulatory availability, longer survival or better quality of life.

without current regulatory confirmation.