Faculty Collaboration Database

Autologous transplant vs chimeric antigen receptor T-cell therapy for relapsed DLBCL in partial remission. Blood 2022 Mar 03;139(9):1330-1339

Date

09/28/2021

Pubmed ID

34570879

Pubmed Central ID

PMC8900276

DOI

10.1182/blood.2021013289

Scopus ID

2-s2.0-85125439632 (requires institutional sign-in at Scopus site)   49 Citations

Abstract

The relative efficacy of autologous hematopoietic cell transplant (auto-HCT) vs chimeric antigen receptor T-cell (CAR-T) therapy in patients with diffuse large B-cell lymphoma (DLBCL) who achieve a partial remission (PR) after salvage chemotherapy is not known. Using the Center for International Blood & Marrow Transplant Research registry database, we identified adult patients with DLBCL who received either an auto-HCT (2013-2019) or CAR-T treatment with axicabtagene ciloleucel (2018-2019) while in a PR by computed tomography or positron emission tomography scan. We compared the clinical outcomes between the 2 cohorts using univariable and multivariable regression models after adjustment for relevant baseline and clinical factors. In the univariable analysis, the 2-year progression-free survival (52% vs 42%; P = .1) and the rate of 100-day nonrelapse mortality (4% vs 2%; P = .3) were not different between the 2 cohorts, but consolidation with auto-HCT was associated with a lower rate of relapse/progression (40% vs 53%; P = .05) and a superior overall survival (OS) (69% vs 47%; P = .004) at 2 years. In the multivariable regression analysis, treatment with auto-HCT was associated with a significantly lower risk of relapse/progression rate (hazard ratio = 1.49; P = .01) and a superior OS (hazard ratio = 1.63; P = .008). In patients with DLBCL in a PR after salvage therapy, treatment with auto-HCT was associated with a lower incidence of relapse and a superior OS compared with CAR-T. These data support the role of auto-HCT as the standard of care in transplant-eligible patients with relapsed DLBCL in PR after salvage therapy.

Author List

Shadman M, Pasquini M, Ahn KW, Chen Y, Turtle CJ, Hematti P, Cohen JB, Khimani F, Ganguly S, Merryman RW, Yared JA, Locke FL, Ahmed N, Munshi PN, Beitinjaneh A, Reagan PM, Herrera AF, Sauter CS, Kharfan-Dabaja MA, Hamadani M

Authors

Kwang Woo Ahn PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin
Peiman Hematti MD Professor in the Medicine department at Medical College of Wisconsin
Marcelo C. Pasquini MD, MS Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Autografts
Disease-Free Survival
Female
Hematopoietic Stem Cell Transplantation
Humans
Immunotherapy, Adoptive
Lymphoma, Large B-Cell, Diffuse
Male
Middle Aged
Recurrence
Survival Rate