Journal
BLOOD
Volume 137, Issue 10, Pages 1416-1423Publisher
AMER SOC HEMATOLOGY
DOI: 10.1182/blood.2020007939
Keywords
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Categories
Funding
- CIBMTR
- National Cancer Institute (NCI)/National Institutes of Health (NIH) [U24CA076518]
- National Heart, Lung, and Blood Institute (NHLBI)/NIH
- NHLBI/NIH [U24HL138660, R21HL140314, U01HL128568, R01HL131731, R01HL126589, 5R01HL129472, 1R01HL131731]
- NCI/NIH [5P01CA111412, R01CA152108, 1R01CA231141]
- Health Resources and Services Administration [HHSH250201700006C, SC1MC31881-01-00]
- Office of Naval Research [N00014-18-1-2888, N00014-17-1-2850]
- NIAID/NIH [1U01AI126612]
- Actinium Pharmaceuticals, Inc.
- Adaptive Biotechnologies
- Astellas Pharma US
- Atara Biotherapeutics, Inc.
- BARDA
- Be the Match Foundation
- bluebird bio, Inc.
- Boston Children's Hospital
- Celgene Corp.
- City of Hope Medical Center
- Daiichi Sankyo Co., Ltd.
- Enterprise Science and Computing, Inc.
- Genzyme
- Gilead Sciences, Inc.
- HistoGenetics, Inc.
- Immucor
- Incyte Corporation
- Janssen Biotech, Inc.
- Janssen Pharmaceuticals, Inc.
- Karius, Inc.
- Karyopharm Therapeutics, Inc.
- Kite, a Gilead Company
- Kyowa Kirin
- Magenta Therapeutics
- Medac GmbH
- Mediware
- Merck Company, Inc.
- Mesoblast
- Meso Scale Diagnostics, Inc.
- Takeda Oncology Co.
- Miltenyi Biotec, Inc.
- Novartis Pharmaceuticals Corporation
- Omeros Corporation
- OncoImmune, Inc.
- REGiMMUNE
- Sanofi Genzyme
- Sobi, Inc.
- Spectrum Pharmaceuticals, Inc.
- St. Baldrick's Foundation
- National Institute of Allergy and Infectious Diseases (NIAID)/NIH
- AlloVir, Inc.
- Amgen, Inc.
- Anthem, Inc.
- Bristol Myers Squibb Co.
- Children's Hospital of Los Angeles
- Chimerix, Inc.
- CSL Behring
- CytoSen Therapeutics, Inc.
- Dana Farber Cancer Institute
- Fred Hutchinson Cancer Research Center
- Gamida-Cell, Ltd.
- GlaxoSmithKline
- Janssen Research & Development, LLC
- Janssen Scientific Affairs, LLC
- Japan Hematopoietic Cell Transplantation Data Center
- Jazz Pharmaceuticals, Inc.
- Mayo Clinic
- Foundation Rochester
- Memorial Sloan-Kettering Cancer Center
- Millennium
- Mundipharma EDO
- National Marrow Donor Program
- Novartis Oncology
- OptumHealth
- Orca Biosystems, Inc.
- PCORI
- Pfizer, Inc.
- Phamacyclics, LLC
- PIRCHE AG
- Regeneron Pharmaceuticals, Inc.
- Seattle Genetics
- Shire
- Swedish Orphan Biovitrum, Inc.
- Takeda Oncology
- Medical College of Wisconsin
- University of Minnesota
- University of Pittsburgh
- University of Texas-MD Anderson
- University of Wisconsin - Madison
- Viracor Eurofins
- Xenikos BV
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For relapsed chemosensitive DLBCL patients with residual PET/CT+ disease prior to auto-HCT, the adjusted 5-year PFS was comparable, irrespective of time to relapse. These data support ongoing application of auto-HCT in chemosensitive DLBCL.
For relapsed chemosensitive diffuse large B-cell lymphoma (DLBCL), consolidation with autologous hematopoietic cell transplantation (auto-HCT) is a standard option. With the approval of anti-CD19 chimeric antigen receptor T cells in 2017, the Center for International Blood and Marrow Transplant Research (CIBMTR) reported an similar to 10% decrease in the number of auto-HCTs for DLBCL in the United States. Using the CIBMTR database, we identified 249 relapsed DLBCL patients undergoing auto-HCT from 2003 to 2013 with a positive positron emission tomography/computed tomography (PET/CT)(+) partial response prior to transplant were identified. The study cohort was divided into 2 groups: early chemoimmunotherapy failure (ECF), defined as patients with primary refractory disease (PRefD) or relapse within 12 months of diagnosis and late chemoimmunotherapy failure, defined as patients relapsing after >= 12 months. Primary outcome was overall survival (OS). Secondary outcomes included progression-free survival (PFS) and relapse. A total of 182 patients had ECF, whereas 67 did not. Among ECF cohort, 79% had PRefD. The adjusted 5-year probabilities for PFS and OS (ECF vs no ECF) were not different: 41% vs 41%(P = .93) and 51% vs 63% (P = .09), respectively. On multivariate analysis, ECF patients had an increased risk for death (hazard ratio, 1.61; 95% confidence interval, 1.05-2.46; P = .03) but not for PFS or relapse. In conclusion, for relapsed chemosensitive DLBCL patients with residual PET/CT+ disease prior to auto-HCT, the adjusted 5-year PFS (41%) was comparable, irrespective of time to relapse. These data support ongoing application of auto-HCT in chemosensitive DLBCL.
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