The salvage role of allogeneic hematopoietic stem-cell transplantation in relapsed/refractory diffuse large B cell lymphoma.

Oct 16, 2023

Experts: Gi-June Min,Young-Woo Jeon,Tong Yoon Kim,Daehun Kwag,Byung-Su Kim,Joonyeop Lee,Jong Hyuk Lee,Sung-Soo Park,Silvia Park,Jae-Ho Yoon,Sung-Eun Lee,Byung-Sik Cho,Ki-Seong Eom,Yoo-Jin Kim,Seok Lee,Hee-Je Kim,Chang-Ki Min,Jong Wook Lee,Seok-Goo Cho

To clarify the role of allogeneic hematopoietic stem-cell transplantation (allo-HSCT) in the chimeric antigen receptor T-cell therapy era, we analyzed the clinical characteristics and outcomes of 52 patients treated with allo-HSCT with relapsed/refractory diffuse large B cell lymphoma. Most enrolled patients had previously undergone intensive treatments, the median number of chemotherapy lines was 4, and the median time from diagnosis to allo-HSCT was 27.1 months. Patients were divided into remission-achieved (n = 30) and active-disease (n = 22) groups before allo-HSCT. Over a median follow-up period of 38.3 months, overall survival (OS) and event-free survival (EFS) rates were 38.4% and 30.6%, respectively. The cumulative incidence of relapse (CIR) and the non-relapsed mortality (NRM) were 36.7% and 32.7%, respectively. OS, EFS, and graft-versus-host disease-free, relapse-free survival (GRFS) outcomes were significantly superior in the remission-achieved group with lower CIR. In a multivariate analysis, a shorter interval from diagnosis to allo-HSCT reflected relatively rapid disease progression and showed significantly poor OS and EFS with higher CIR. Patients with active disease had significantly lower EFS, GRFS, and higher CIR. Previous autologous stem-cell transplantation was associated with better GRFS. Allo-HSCT is an established modality with a prominent group of cured patients and still has a role in the CAR T-cell era, particularly given its acceptable clinical outcomes in young patients with chemo-susceptible disease.
© 2023. Springer Nature Limited.

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ABOUT THE EXPERTS

Gi-June Min,Young-Woo Jeon,Tong Yoon Kim,Daehun Kwag,Byung-Su Kim,Joonyeop Lee,Jong Hyuk Lee,Sung-Soo Park,Silvia Park,Jae-Ho Yoon,Sung-Eun Lee,Byung-Sik Cho,Ki-Seong Eom,Yoo-Jin Kim,Seok Lee,Hee-Je Kim,Chang-Ki Min,Jong Wook Lee,Seok-Goo Cho

Gi-June Min

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Young-Woo Jeon

Department of Hematology, Yeouido St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, Republic of Korea.

Tong Yoon Kim

Department of Hematology, Yeouido St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, Republic of Korea.

Daehun Kwag

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Byung-Su Kim

Department of Hematology, Eunpyeong St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil Ro, Eunpyeong-gu, Seoul, Republic of Korea.

Joonyeop Lee

Department of Hematology, Eunpyeong St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil Ro, Eunpyeong-gu, Seoul, Republic of Korea.

Jong Hyuk Lee

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Sung-Soo Park

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Silvia Park

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Jae-Ho Yoon

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Sung-Eun Lee

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Byung-Sik Cho

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Ki-Seong Eom

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Yoo-Jin Kim

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Seok Lee

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Hee-Je Kim

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Chang-Ki Min

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Jong Wook Lee

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Seok-Goo Cho

Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea. chosg@catholic.ac.kr.