Do all roads lead to Rome? The heterogeneity of relapsed/refractory diffuse large B-cell lymphoma patients who achieved therapies response and received autologous stem cell transplantation in the era of new targeted drugs

条条大路通罗马吗?在新型靶向药物时代,接受治疗后获得疗效并进行自体干细胞移植的复发/难治性弥漫性大B细胞淋巴瘤患者的异质性

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Abstract

In this multicenter study, we aimed to identify the prognostic factors for relapsed/refractory diffuse large B-cell lymphoma (DLBCL) patients who received autologous stem cell transplantation (ASCT) in the era of novel agents and chimeric antigen receptor (CAR) T-cell therapy. A total of 82 relapsed/refractory DLBCL patients receiving ASCT across four transplant centers were enrolled. The 3-year probabilities of disease progression, non-relapse mortality (NRM), progression-free survival (PFS), and overall survival (OS) were 23.5%, 2.8%, 73.7%, and 91.4%, respectively. Patients who received Pola-R-CHP before ASCT had a higher disease progression rate (85.7% vs. 18.4%, P = 0.034) and a poorer PFS (0% vs. 79.9%, P < 0.001) after ASCT compared with those who did not receive Pola-R-CHP. Patients who received BTKi before ASCT had a higher disease progression rate (60.0% vs. 18.2%, P = 0.025) and a poorer PFS rate (23.8% vs. 81.8%, P < 0.001) after ASCT compared with those who did not receive BTKi. In multivariate analysis, receiving novel agents before ASCT was independently associated with a higher risk of disease progression and worse PFS. In summary, we observed the heterogeneity of relapsed/refractory DLBCL patients who achieved therapies response and received ASCT, and some of them might not benefit from ASCT.

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