4.7 Article

Is autologous transplant in relapsed DLBCL patients achieving only a PET+ PR appropriate in the CAR T-cell era?

Journal

BLOOD
Volume 137, Issue 10, Pages 1416-1423

Publisher

AMER SOC HEMATOLOGY
DOI: 10.1182/blood.2020007939

Keywords

-

Categories

Funding

  1. CIBMTR
  2. National Cancer Institute (NCI)/National Institutes of Health (NIH) [U24CA076518]
  3. National Heart, Lung, and Blood Institute (NHLBI)/NIH
  4. NHLBI/NIH [U24HL138660, R21HL140314, U01HL128568, R01HL131731, R01HL126589, 5R01HL129472, 1R01HL131731]
  5. NCI/NIH [5P01CA111412, R01CA152108, 1R01CA231141]
  6. Health Resources and Services Administration [HHSH250201700006C, SC1MC31881-01-00]
  7. Office of Naval Research [N00014-18-1-2888, N00014-17-1-2850]
  8. NIAID/NIH [1U01AI126612]
  9. Actinium Pharmaceuticals, Inc.
  10. Adaptive Biotechnologies
  11. Astellas Pharma US
  12. Atara Biotherapeutics, Inc.
  13. BARDA
  14. Be the Match Foundation
  15. bluebird bio, Inc.
  16. Boston Children's Hospital
  17. Celgene Corp.
  18. City of Hope Medical Center
  19. Daiichi Sankyo Co., Ltd.
  20. Enterprise Science and Computing, Inc.
  21. Genzyme
  22. Gilead Sciences, Inc.
  23. HistoGenetics, Inc.
  24. Immucor
  25. Incyte Corporation
  26. Janssen Biotech, Inc.
  27. Janssen Pharmaceuticals, Inc.
  28. Karius, Inc.
  29. Karyopharm Therapeutics, Inc.
  30. Kite, a Gilead Company
  31. Kyowa Kirin
  32. Magenta Therapeutics
  33. Medac GmbH
  34. Mediware
  35. Merck Company, Inc.
  36. Mesoblast
  37. Meso Scale Diagnostics, Inc.
  38. Takeda Oncology Co.
  39. Miltenyi Biotec, Inc.
  40. Novartis Pharmaceuticals Corporation
  41. Omeros Corporation
  42. OncoImmune, Inc.
  43. REGiMMUNE
  44. Sanofi Genzyme
  45. Sobi, Inc.
  46. Spectrum Pharmaceuticals, Inc.
  47. St. Baldrick's Foundation
  48. National Institute of Allergy and Infectious Diseases (NIAID)/NIH
  49. AlloVir, Inc.
  50. Amgen, Inc.
  51. Anthem, Inc.
  52. Bristol Myers Squibb Co.
  53. Children's Hospital of Los Angeles
  54. Chimerix, Inc.
  55. CSL Behring
  56. CytoSen Therapeutics, Inc.
  57. Dana Farber Cancer Institute
  58. Fred Hutchinson Cancer Research Center
  59. Gamida-Cell, Ltd.
  60. GlaxoSmithKline
  61. Janssen Research & Development, LLC
  62. Janssen Scientific Affairs, LLC
  63. Japan Hematopoietic Cell Transplantation Data Center
  64. Jazz Pharmaceuticals, Inc.
  65. Mayo Clinic
  66. Foundation Rochester
  67. Memorial Sloan-Kettering Cancer Center
  68. Millennium
  69. Mundipharma EDO
  70. National Marrow Donor Program
  71. Novartis Oncology
  72. OptumHealth
  73. Orca Biosystems, Inc.
  74. PCORI
  75. Pfizer, Inc.
  76. Phamacyclics, LLC
  77. PIRCHE AG
  78. Regeneron Pharmaceuticals, Inc.
  79. Seattle Genetics
  80. Shire
  81. Swedish Orphan Biovitrum, Inc.
  82. Takeda Oncology
  83. Medical College of Wisconsin
  84. University of Minnesota
  85. University of Pittsburgh
  86. University of Texas-MD Anderson
  87. University of Wisconsin - Madison
  88. Viracor Eurofins
  89. Xenikos BV

Ask authors/readers for more resources

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.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.7
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available