TY - JOUR
T1 - Allogeneic transplant following CAR T-cell therapy for large B-cell lymphoma
AU - Zurko, Joanna
AU - Ramdial, Jeremy
AU - Shadman, Mazyar
AU - Ahmed, Sairah
AU - Szabo, Aniko
AU - Iovino, Lorenzo
AU - Tomas, Ana Alarcon
AU - Sauter, Craig
AU - Perales, Miguel Angel
AU - Shah, Nirav N.
AU - Acharya, Utkarsh H.
AU - Jacobson, Caron
AU - Soiffer, Robert J.
AU - Wang, Trent
AU - Komanduri, Krishna V.
AU - Jaglowski, Samantha
AU - Kittai, Adam S.
AU - Denlinger, Nathan
AU - Iqbal, Madiha
AU - Kharfan-Dabaja, Mohamed A.
AU - Ayala, Ernesto
AU - Chavez, Julio
AU - Jain, Michael
AU - Locke, Frederick L.
AU - Samara, Yazeed
AU - Budde, Lihua E.
AU - Mei, Matthew G.
AU - Pia, Alexandra Della
AU - Feldman, Tatyana
AU - Ahmed, Nausheen
AU - Jacobs, Ryan
AU - Ghosh, Nilanjan
AU - Dholaria, Bhagirathbhai
AU - Oluwole, Olalekan O.
AU - Hess, Brian
AU - Hassan, Ayesha
AU - Kenkre, Vaishalee P.
AU - Reagan, Patrick
AU - Awan, Farrukh
AU - Nieto, Yago
AU - Hamadani, Mehdi
AU - Herrera, Alex F.
N1 - Publisher Copyright:
©2023 Ferrata Storti Foundation.
PY - 2023/1
Y1 - 2023/1
N2 - Allogeneic hematopoietic cell transplantation (alloHCT) can potentially salvage large B-cell lymphoma (LBCL) patients experiencing treatment failure after chimeric antigen receptor T-cell therapy (CAR T). Nonetheless, data on the efficacy and toxicities of alloHCT after receipt of CAR T are limited. We report a multicenter retrospective study assessing the safety, toxicities, and outcomes of alloHCT in LBCL patients following CAR T failure. Eighty-eight patients with relapsed, refractory LBCL received an alloHCT following anti-CD19 CAR T failure. The median number of lines of therapy between CAR T infusion and alloHCT was one (range, 0-7). Low intensity conditioning was used in 77% (n=68) and peripheral blood was the most common graft source (86%, n=76). The most common donor types were matched unrelated donor (39%), followed by haploidentical (30%) and matched related donor (26%). Median follow-up of survivors was 15 months (range, 1-72). One-year overall survival, progression-free survival, and graft-versus-host disease-free relapse-free survival were 59%, 45%, and 39% respectively. One-year non-relapse mortality and progression/relapse were 22% and 33% respectively. On multivariate analysis, <2 lines of intervening therapy between CAR T and alloHCT and complete response at time of alloHCT were associated with better outcomes. In conclusion, alloHCT after CAR T failure can provide durable remissions in a subset of patients.
AB - Allogeneic hematopoietic cell transplantation (alloHCT) can potentially salvage large B-cell lymphoma (LBCL) patients experiencing treatment failure after chimeric antigen receptor T-cell therapy (CAR T). Nonetheless, data on the efficacy and toxicities of alloHCT after receipt of CAR T are limited. We report a multicenter retrospective study assessing the safety, toxicities, and outcomes of alloHCT in LBCL patients following CAR T failure. Eighty-eight patients with relapsed, refractory LBCL received an alloHCT following anti-CD19 CAR T failure. The median number of lines of therapy between CAR T infusion and alloHCT was one (range, 0-7). Low intensity conditioning was used in 77% (n=68) and peripheral blood was the most common graft source (86%, n=76). The most common donor types were matched unrelated donor (39%), followed by haploidentical (30%) and matched related donor (26%). Median follow-up of survivors was 15 months (range, 1-72). One-year overall survival, progression-free survival, and graft-versus-host disease-free relapse-free survival were 59%, 45%, and 39% respectively. One-year non-relapse mortality and progression/relapse were 22% and 33% respectively. On multivariate analysis, <2 lines of intervening therapy between CAR T and alloHCT and complete response at time of alloHCT were associated with better outcomes. In conclusion, alloHCT after CAR T failure can provide durable remissions in a subset of patients.
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UR - http://www.scopus.com/inward/citedby.url?scp=85144275501&partnerID=8YFLogxK
U2 - 10.3324/haematol.2022.281242
DO - 10.3324/haematol.2022.281242
M3 - Article
C2 - 35833303
AN - SCOPUS:85144275501
SN - 0390-6078
VL - 108
SP - 98
EP - 109
JO - Haematologica
JF - Haematologica
IS - 1
ER -