- Patients with chemosensitive DLBCL experience prolonged survival after ASCT - Complete response before transplant is associated with better survival> Intensification of salvage treatment might lead to superior outcomes In the era of CAR T cell therapy, autologous stem cell transplant (ASCT) for diffuse large B cell lymphoma (DLBCL) is preferentially offered to patients with late relapse (>12 months) who achieve a complete or partial response (CR or PR) to salvage therapy. We conducted a retrospective cohort study using publicly available data from the Center for International Blood and Marrow Transplant Research (CIBMTR) in this population. We included adult patients with DLBCL, NOS, and high-grade large B-cell lymphomas (HGBL) who relapsed after remaining on a response to first line of treatment for at least 12 months and who achieved a CR or PR after salvage treatment at the time of relapse. One hundred and eighty-two patients treated between 2013 and 2021 were included in the analysis: 100 were in CR and 82 in PR before ASCT. Median follow-up after ASCT was 34 (range, 1–95) months. OS at 3 years was 67.6% and PFS was 50.6%. Cumulative incidence of relapse at 3 years was 43.9%. Older age (HR 1.03; p=.026) and a higher number of previous lines of treatment (HR 1.43; P=.002) were associated with inferior OS. Multivariable analysis (MVA) showed that the number of previous treatments had a significant impact on the OS (P=.009), while undergoing ASCT in a PR status was the only factor significantly associated with inferior PFS (P=.029. HR 1.41. 95% CI, 1.09-1.82). In summary, ASCT still provides high efficacy in patients experiencing late relapses (after 12 months) who have chemosensitive disease following pre-transplant salvage.
Iovino et al. (Wed,) studied this question.