학술논문
Role of allogeneic hematopoietic cell transplant for relapsed/refractory aggressive B-cell lymphomas in the CART era
Document Type
Article
Author
Mussetti, Alberto; Bento, Leyre; Bastos-Oreiro, Mariana; Rius-Sansalvador, Blanca; Albo, Carmen; Bailen, Rebeca; Barba, Pere; Benzaquén, Ana; Briones, Javier; Caballero, Ana Carolina; Campos, António; Español, Ignacio; Ferra, Christelle; López, Sebastián Garzón; González Sierra, Pedro Antonio; Guerra, Luisa Maria; Hernani, Rafael; Iacoboni, Gloria; Jiménez-Ubieto, Ana; Kwon, Mi; Corral, Lucía López; López-Godino, Oriana; Munoz, Maria Carmen Martinez; Martínez-Cibrián, Nuria; Gómez, Juan Montoro; Pérez-Ortega, Laura; Ortí, Guillermo; Ortiz-Maldonado, Valentín; Pascual, Maria-Jesús; Perera, María; Perez, Antonio; Reguera, Juan Luis; Sanchez, Jose M.; Sanz, Jaime; Torrent, Anna; Yáñez, Lucrecia; Varela, Rosario; Echechipia, Izaksun Ceberio; Caballero, Dolores; Sureda, Anna
Source
Bone Marrow Transplantation; 20230101, Issue: Preprints p1-7, 7p
Subject
Language
ISSN
02683369; 14765365
Abstract
Anti-CD19 chimeric antigen receptor T cells (CART) has rapidly been adopted as the standard third-line therapy to treat aggressive B-cell lymphomas (ABCL) after failure of second-line therapy despite the lack of direct comparisons with allogeneic hematopoietic cell transplantation (alloHCT)-based strategies. Using the Grupo Español de Trasplante y Terapia Celular(GETH-TC) registry, we selected patients with the following characteristics: CART or alloHCT performed between 2016 and 2021; ≥18 years old; ABCL diagnosis; ≥2 lines of therapy; and either anti-CD19 CART or alloHCT as therapy at relapse. The analysis included a total of 316 (CART = 215, alloHCT = 101) patients. Median follow-up was 15 and 36 months for the CART and alloHCT cohorts, respectively. In the multivariate analysis, CART was confirmed to be similar to alloHCT for the primary study endpoint (progression-free survival) (hazard ratio [HR] 0.92, CI95%:0.56–1.51, p= 0.75). Furthermore, when the analysis was limited to only patients with chemo-sensitive diseases (complete and partial response) at infusion (CART = 26, alloHCT=93), no differences were reported (progression-free survival at month +18: 65% versus 55%, p= 0.59). However, CART had lower non-relapse mortality (HR 0.34, 95% CI: 0.13–0.85, p= 0.02). Given the lower toxicity and similar survival outcomes, these results suggest the use of CART before alloHCT.