The salvage role of allogeneic hematopoietic stem-cell transplantation in relapsed/refractory diffuse large B cell lymphoma

To clarify the role of allogeneic hematopoietic stem-cell transplantation (allo-HSCT) in the chimeric antigen receptor T-cell therapy era, we analyzed the clinical characteristics and outcomes of 52 patients treated with allo-HSCT with relapsed/refractory diffuse large B cell lymphoma. Most enrolled...

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Published in:Scientific reports 2023-10, Vol.13 (1), p.17496-17496, Article 17496
Main Authors: Min, Gi-June, Jeon, Young-Woo, Kim, Tong Yoon, Kwag, Daehun, Kim, Byung-Su, Lee, Joonyeop, Lee, Jong Hyuk, Park, Sung-Soo, Park, Silvia, Yoon, Jae-Ho, Lee, Sung-Eun, Cho, Byung-Sik, Eom, Ki-Seong, Kim, Yoo-Jin, Lee, Seok, Kim, Hee-Je, Min, Chang-Ki, Lee, Jong Wook, Cho, Seok-Goo
Format: Article
Language:English
Subjects:
631/532/1542
631/67/1990
Allografts
B-cell lymphoma
Cell therapy
Chemotherapy
Chimeric antigen receptors
Diagnosis
Graft-versus-host reaction
Hematopoietic stem cells
Humanities and Social Sciences
Lymphocytes T
Lymphoma
multidisciplinary
Multivariate analysis
Remission
Remission (Medicine)
Science
Science (multidisciplinary)
Stem cell transplantation
Transplantation
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Summary:To clarify the role of allogeneic hematopoietic stem-cell transplantation (allo-HSCT) in the chimeric antigen receptor T-cell therapy era, we analyzed the clinical characteristics and outcomes of 52 patients treated with allo-HSCT with relapsed/refractory diffuse large B cell lymphoma. Most enrolled patients had previously undergone intensive treatments, the median number of chemotherapy lines was 4, and the median time from diagnosis to allo-HSCT was 27.1 months. Patients were divided into remission-achieved (n = 30) and active-disease (n = 22) groups before allo-HSCT. Over a median follow-up period of 38.3 months, overall survival (OS) and event-free survival (EFS) rates were 38.4% and 30.6%, respectively. The cumulative incidence of relapse (CIR) and the non-relapsed mortality (NRM) were 36.7% and 32.7%, respectively. OS, EFS, and graft-versus-host disease-free, relapse-free survival (GRFS) outcomes were significantly superior in the remission-achieved group with lower CIR. In a multivariate analysis, a shorter interval from diagnosis to allo-HSCT reflected relatively rapid disease progression and showed significantly poor OS and EFS with higher CIR. Patients with active disease had significantly lower EFS, GRFS, and higher CIR. Previous autologous stem-cell transplantation was associated with better GRFS. Allo-HSCT is an established modality with a prominent group of cured patients and still has a role in the CAR T-cell era, particularly given its acceptable clinical outcomes in young patients with chemo-susceptible disease.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-023-44241-0