Auto-HCT or CAR T-Cell Therapy for DLBCL in PR

Shadman M, Pasquini MC, Ahn KW, et al. Autologous Transplant versus Chimeric Antigen Receptor T-cell Therapy for Relapsed DLBCL in Partial Remission. Blood. 2021; (doi: 10.1182/blood.2021013289).

Autologous hematopoietic cell transplant (auto-HCT) was superior to chimeric antigen receptor T-cell (CAR-T) therapy in patients with relapsed diffuse large B-cell lymphoma (DLBCL) in partial remission (PM) after salvage therapy, a new study shows. Auto-HCT yielded lower relapse incidence and better overall survival (OS). The researchers identified adult DLBCL patients who underwent an auto-HCT or CAR-T regimen with axicabtagene ciloleucel while in PR using computed tomography (CT) or positron emission tomography (PET) scan through the Center for International Blood & Marrow Transplant Research registry database. Univariable analysis showed no substantial difference between cohorts for two-year progression-free survival (52% vs. 42%) and 100-day non-relapse mortality rate (4% vs. 2%). However, consolidation with auto-HCT correlated with reduced relapse/progression (40% vs. 53%) and improved OS (69% vs. 47%) at 2 years. Multivariable regression analysis also observed a significantly lower risk of relapse/progression rate and superior OS with auto-HCT.

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