Clinical Features and Outcomes of Patients with T-Cell/Histiocyte-Rich Large B-Cell Lymphoma: A Single-Center Analysis

• Published in: Blood 2024-11, Vol.144 (Supplement 1), p.1717-1717
• Main Authors: Romancik, Jason T, Baird, Katelin, Marra, Angelo Thomas, Langston, Amelia, Allen, Pamela B., Cohen, Jonathon B., Koff, Jean L., Lechowicz, Mary Jo, Switchenko, Jeffrey M., Blum, Kristie A.
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2024-211784

Introduction: T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is a rare subtype of diffuse large B-cell lymphoma characterized by unique pathobiologic features and historically poor outcomes. Recent evidence presented at ASH suggests that intensive first-line (1L) therapy such as alternating R-CHOP/R-ICE or R-EPOCH may improve disease control (Robin ET et al, 2020; Nair R et al, 2021). There are limited data describing outcomes for patients with relapsed THRLBCL treated with autologous stem cell transplant (ASCT) and chimeric antigen receptor T-cell therapy (CAR-T). The optimal treatment for patients with this disease remains unclear. Methods: We conducted a single-center, retrospective analysis of patients (pts) diagnosed with THRLBCL treated at Emory Winship Cancer Institute between January 2000 and December 2023. Pt characteristics, pathology results, treatment regimens used, and clinical outcomes were abstracted. Univariate models were assessed for significance using chi-square tests and t-tests. Overall survival (OS) was defined as the time from diagnosis to last follow-up or death. Progression-free survival (PFS) was defined as the time from treatment initiation to relapse, death, or last follow-up. Survival curves were estimated using the Kaplan-Meier method. Results: 71 THRLBCL cases were identified. All had central pathology review at Emory. Twenty-one pts were excluded due to lack of baseline characteristics and follow-up data, resulting in a total of 50 pts included for analysis. Thirty pts (60%) were male. Median age at diagnosis was 45 years (range 19-77 yrs). Twenty-six (52%) self-reported black race/ethnicity. Thirty-one pts (62%) had stage IV disease, 30 (60%) had extranodal involvement, and 18 (36%) had > 2 extranodal sites of disease. Nine pts (18%) were previously diagnosed with nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) at a median of 4 yrs (range 0.8-11.8 yrs) before THRLBCL diagnosis, and 8 pts (16%) were diagnosed concurrently with NLPHL and THRLBCL. Univariable analysis did not reveal any significant associations between patient sex, race/ethnicity, stage, number of extranodal sites, disease bulk, or history of NLPHL and OS. 1L therapy consisted of CHOP-based chemo in 44 pts (88%; includes CHOP n=2, R-CHOP n=39, R-pola-CHP n=3) and intensified chemotherapy in 6 (12%). Two pts received ASCT in first remission for THRLBCL; both had prior anthracycline-based treatment for NLPHL. Thirty-four pts (68%) achieved CR aft