HCT for DLBCL-Richter Transformation

Herrera AF, Ahn KW, Litovich CA, et al. Autologous and Allogeneic Hematopoietic Cell Transplantation for Diffuse Large B-cell Lymphoma-Type Richter Syndrome. Blood Advances. 2021; (doi: 10.1182/bloodadvances.2021004865).

A Center for International Blood and Marrow Transplant Research registry study observed durable remissions when therapy-sensitive patients with diffuse large B-cell lymphoma Richter syndrome (DLBCL-RS) underwent autologous and allogeneic hematopoietic cell transplantation (HCT). As the treatment landscape for chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) has evolved significantly in recent years, researchers sought to evaluate the effect of clinical prognostic factors, cytogenetic abnormalities, and the use of novel agents on HCT outcomes. For the study, 53 DLBCL-RS patients underwent auto-HCT and 118 underwent allo-HCT. At 66%, more auto-HCT recipients were in complete response at HCT compared with 34% of all-HCT recipients. But more allo-HCT recipients than auto-HCT recipients had 17p deletion (33% vs. 7%) and had received novel agents in the past (39% vs. 10%). The respective 3-year relapse incidence, progression-free survival, and overall survival in the auto-HCT group were 37%, 48%, and 57%, compared with 30%, 43%, and 52% in the allo-HCT group. A deeper response affected these outcomes at HCT in the allo-HCT cohort, while cytogenetic abnormalities and prior novel therapy did not impact outcomes.

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