OUTCOME OF PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA RELAPSING AFTER AUTOLOGOUS TRANSPLANT BEFORE AVAILABILITY OF CAR-T CELL TREATMENT
Introduction: Autologous stem cell transplantation (ASCT) following high-dose chemotherapy is applied for patients with relapsed/refractory (r/r) DLBCL. However, prognosis of relapsing DLBCL post-ASCT remained poor until the availability of CAR-T cell treatment. To appreciate this development, unde...
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PAGEPress Publications
2023-04-01
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| Series: | Mediterranean Journal of Hematology and Infectious Diseases |
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| Online Access: | http://www.mjhid.org/index.php/mjhid/article/view/5244 |
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| author | Ulrike Bacher Stefanie von Matt Yara Banz Behrouz Mansouri Taleghani Urban Novak Thomas Pabst |
| author_facet | Ulrike Bacher Stefanie von Matt Yara Banz Behrouz Mansouri Taleghani Urban Novak Thomas Pabst |
| author_sort | Ulrike Bacher |
| collection | DOAJ |
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Introduction: Autologous stem cell transplantation (ASCT) following high-dose chemotherapy is applied for patients with relapsed/refractory (r/r) DLBCL. However, prognosis of relapsing DLBCL post-ASCT remained poor until the availability of CAR-T cell treatment. To appreciate this development, understanding the outcome of these patients in the pre-CAR-T era is essential.
Methods: We retrospectively analyzed 125 consecutive DLBCL patients who underwent HDCT/ASCT.
Results: After a median follow-up of 26 months, OS and PFS were 65% and 55%. 53 patients (42%) had a relapse (32 patients, 60%) or refractory disease (21 patients, 40%) after a median of 3 months post-ASCT. 81% of relapses occurred within the first year post-ASCT with an OS of 19% versus 40% at last follow-up in patients with later relapses (p=0.0022). Patients with r/r disease after ASCT had inferior OS compared to patients in ongoing remission (23% versus 96%; p<0.0001). Patients relapsing post-ASCT without salvage therapy (n=22) had worse OS than patients with 1-4 subsequent treatment lines (n=31) (OS 0% versus 39%; median OS 3 versus 25 months; p<0.0001). 41 (77%) of patients relapsing after ASCT died, 35 of which due to progression.
Conclusions: Additional therapies can extend OS, but mostly cannot prevent death in DLBCL relapsing/refractory post-ASCT. This study may serve as reference to emerging results after CAR-T treatment in this population.
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| format | Article |
| id | doaj-art-601b18a0eecb4fb3aca4d1502d36b86d |
| institution | Kabale University |
| issn | 2035-3006 |
| language | English |
| publishDate | 2023-04-01 |
| publisher | PAGEPress Publications |
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| series | Mediterranean Journal of Hematology and Infectious Diseases |
| spelling | doaj-art-601b18a0eecb4fb3aca4d1502d36b86d2025-01-02T20:14:53ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062023-04-0115110.4084/MJHID.2023.025OUTCOME OF PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA RELAPSING AFTER AUTOLOGOUS TRANSPLANT BEFORE AVAILABILITY OF CAR-T CELL TREATMENTUlrike BacherStefanie von Matt0Yara Banz1Behrouz Mansouri Taleghani2Urban Novak3Thomas Pabst4Department of Medical Oncology, Inselspital, Bern University Hospital, SwitzerlandInstitute of Pathology, University of Bern, Bern, SwitzerlandDepartment of Hematology, Inselspital, Bern University Hospital, Bern, SwitzerlandDepartment of Medical Oncology, Inselspital, Bern University Hospital, Bern, SwitzerlandDepartment of Medical Oncology, Inselspital, Bern University Hospital, Bern, Switzerland Introduction: Autologous stem cell transplantation (ASCT) following high-dose chemotherapy is applied for patients with relapsed/refractory (r/r) DLBCL. However, prognosis of relapsing DLBCL post-ASCT remained poor until the availability of CAR-T cell treatment. To appreciate this development, understanding the outcome of these patients in the pre-CAR-T era is essential. Methods: We retrospectively analyzed 125 consecutive DLBCL patients who underwent HDCT/ASCT. Results: After a median follow-up of 26 months, OS and PFS were 65% and 55%. 53 patients (42%) had a relapse (32 patients, 60%) or refractory disease (21 patients, 40%) after a median of 3 months post-ASCT. 81% of relapses occurred within the first year post-ASCT with an OS of 19% versus 40% at last follow-up in patients with later relapses (p=0.0022). Patients with r/r disease after ASCT had inferior OS compared to patients in ongoing remission (23% versus 96%; p<0.0001). Patients relapsing post-ASCT without salvage therapy (n=22) had worse OS than patients with 1-4 subsequent treatment lines (n=31) (OS 0% versus 39%; median OS 3 versus 25 months; p<0.0001). 41 (77%) of patients relapsing after ASCT died, 35 of which due to progression. Conclusions: Additional therapies can extend OS, but mostly cannot prevent death in DLBCL relapsing/refractory post-ASCT. This study may serve as reference to emerging results after CAR-T treatment in this population. http://www.mjhid.org/index.php/mjhid/article/view/5244autologous stem cell transplantation (ASCT)diffuse large B-cell lymphoma (DLBCL) |
| spellingShingle | Ulrike Bacher Stefanie von Matt Yara Banz Behrouz Mansouri Taleghani Urban Novak Thomas Pabst OUTCOME OF PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA RELAPSING AFTER AUTOLOGOUS TRANSPLANT BEFORE AVAILABILITY OF CAR-T CELL TREATMENT Mediterranean Journal of Hematology and Infectious Diseases autologous stem cell transplantation (ASCT) diffuse large B-cell lymphoma (DLBCL) |
| title | OUTCOME OF PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA RELAPSING AFTER AUTOLOGOUS TRANSPLANT BEFORE AVAILABILITY OF CAR-T CELL TREATMENT |
| title_full | OUTCOME OF PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA RELAPSING AFTER AUTOLOGOUS TRANSPLANT BEFORE AVAILABILITY OF CAR-T CELL TREATMENT |
| title_fullStr | OUTCOME OF PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA RELAPSING AFTER AUTOLOGOUS TRANSPLANT BEFORE AVAILABILITY OF CAR-T CELL TREATMENT |
| title_full_unstemmed | OUTCOME OF PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA RELAPSING AFTER AUTOLOGOUS TRANSPLANT BEFORE AVAILABILITY OF CAR-T CELL TREATMENT |
| title_short | OUTCOME OF PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA RELAPSING AFTER AUTOLOGOUS TRANSPLANT BEFORE AVAILABILITY OF CAR-T CELL TREATMENT |
| title_sort | outcome of patients with diffuse large b cell lymphoma relapsing after autologous transplant before availability of car t cell treatment |
| topic | autologous stem cell transplantation (ASCT) diffuse large B-cell lymphoma (DLBCL) |
| url | http://www.mjhid.org/index.php/mjhid/article/view/5244 |
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