@article{b730e2466dc54eea98cf0d2db802ebfe,
title = "Autologous transplant vs chimeric antigen receptor T-cell therapy for relapsed DLBCL in partial remission",
abstract = "The relative efficacy of autologous hematopoietic cell transplant (auto-HCT) vs chimeric antigen receptor T-cell (CAR-T) therapy in patients with diffuse large B-cell lymphoma (DLBCL) who achieve a partial remission (PR) after salvage chemotherapy is not known. Using the Center for International Blood & Marrow Transplant Research registry database, we identified adult patients with DLBCL who received either an auto-HCT (2013-2019) or CAR-T treatment with axicabtagene ciloleucel (2018-2019) while in a PR by computed tomography or positron emission tomography scan. We compared the clinical outcomes between the 2 cohorts using univariable and multivariable regression models after adjustment for relevant baseline and clinical factors. In the univariable analysis, the 2-year progression-free survival (52% vs 42%; P = .1) and the rate of 100-day nonrelapse mortality (4% vs 2%; P = .3) were not different between the 2 cohorts, but consolidation with auto-HCT was associated with a lower rate of relapse/progression (40% vs 53%; P = .05) and a superior overall survival (OS) (69% vs 47%; P = .004) at 2 years. In the multivariable regression analysis, treatment with auto-HCT was associated with a significantly lower risk of relapse/progression rate (hazard ratio = 1.49; P = .01) and a superior OS (hazard ratio = 1.63; P = .008). In patients with DLBCL in a PR after salvage therapy, treatment with auto-HCT was associated with a lower incidence of relapse and a superior OS compared with CAR-T. These data support the role of auto-HCT as the standard of care in transplant-eligible patients with relapsed DLBCL in PR after salvage therapy.",
keywords = "Adolescent, Adult, Aged, Aged, 80 and over, Autografts, Disease-Free Survival, Female, Hematopoietic Stem Cell Transplantation, Humans, Immunotherapy, Adoptive, Lymphoma, Large B-Cell, Diffuse/mortality, Male, Middle Aged, Recurrence, Survival Rate",
author = "Mazyar Shadman and Marcelo Pasquini and Ahn, {Kwang Woo} and Yue Chen and Turtle, {Cameron J.} and Peiman Hematti and Cohen, {Jonathon B.} and Farhad Khimani and Siddhartha Ganguly and Merryman, {Reid W.} and Yared, {Jean A.} and Locke, {Frederick L.} and Nausheen Ahmed and Munshi, {Pashna N.} and Amer Beitinjaneh and Reagan, {Patrick M.} and Herrera, {Alex F.} and Sauter, {Craig S.} and Kharfan-Dabaja, {Mohamed A.} and Mehdi Hamadani",
note = "Funding Information: Conflict-of-interest disclosure: M.S. reports consulting, advisory Boards, steering committees or data safety monitoring committees: Abbvie, Genentech, AstraZeneca, Sound Biologics, Pharmacyclics, Beigene, Bristol Myers Squibb, Morphosys, TG Therapeutics, Innate Pharma, Kite Pharma, Adaptive Biotechnologies, Epizyme, Eli Lilly, Adaptimmune, and Atara Biotherapeutics; research funding: Mustang Bio, Celgene, Bristol Myers Squibb, Pharmacyclics, Gilead, Genentech, Abbvie, TG Therapeutics, Beigene, AstraZeneca, Sunesis, Atara Biotherapeutics, and GenMab. M.A.K.-D. reports other from Daiichi Sankyo, outside the submitted work. C.S.S. reports grants from Juno Therapeutics, Celgene, Bristol-Myers Squibb, Precision Biosciences, and Sanofi Genzyme; personal fees from Precision Biosciences, Sanofi Genzyme, Juno Therapeutics, Spectrum Pharmaceuticals, Novartis, Genmab, Kite (a Gilead Company), Celgene, Gamida Cell, Karyopharm Therapeutics, and GlaxoSmithKline, outside the submitted work. A.F.H. reports research funding from BMS, Merck, Genentech, Inc./F. Hoffmann-La Roche Ltd, Gilead Sciences, Seattle Genetics, AstraZeneca, and ADC Therapeutics; consultancy for BMS, Merck, Genentech, Inc./F. Hoffmann-La Roche Ltd, Gilead Sciences, Seattle Genetics, and Karyopharm; travel, accommodations, and expenses from BMS. M.H. reports research support/funding: Takeda Pharmaceutical Company, Spectrum Pharmaceuticals, and Astellas Pharma; consultancy: Janssen, Incyte Corporation, ADC Therapeutics, Celgene Corporation, Omeros, Verastem, and MorphoSys; speaker's bureau: Sanofi Genzyme, AstraZeneca, and BeiGene. F.L.L. reports scientific advisory role: Allogene, Amgen, Bluebird Bio, BMS/Celgene, Calibr, Cellular Biomedicine Group, GammaDelta Therapeutics, Iovance, Kite Pharma, Janssen, Legend Biotech, Novartis, Wugen, and Umoja; research funding: Kite Pharma (institutional), Allogene (institutional), Novartis (institutional); and patents, royalties, and other intellectual property: several patents held by the institution in my name (unlicensed) in the field of cellular immunotherapy. C.J.T. reports research funding: Juno Therapeutics/BMS, Nektar Therapeutics, and AstraZeneca; scientific sdvisory boards: Precision Biosciences, Eureka Therapeutics, Caribou Biosciences, T-CURX, Myeloid Therapeutics, ArsenalBio, and Century Therapeutics; ad hoc advisory boards (past 12 months): Allogene, Amgen, and AsherBio; stock/options: Precision Biosciences, Eureka Therapeutics, Caribou Biosciences, Myeloid Therapeutics, and ArsenalBio; patents: has the right to receive royalties from Fred Hutchinson as an inventor on patents related to CAR T-cell therapy that are licensed to Juno Therapeutics/BMS. Funding Information: The CIBMTR is supported primarily by grants from the National Institutes of Health National Cancer Institute (NCI) Public Health Service (U24CA076518), the National Heart, Lung and Blood Institute, and the National Institute of Allergy and Infectious Diseases; NCI (U24CA233032), Health Resources and Services Administration (HHSH250201700006C), the Office of Naval Research (N00014-20-1-2705 and N00014-20-1-2832). Support is also provided by Be the Match Foundation, the Medical College of Wisconsin, the National Marrow Donor Program, and from the following commercial entities: AbbVie, Accenture, Actinium Pharmaceuticals Inc. Adaptive Biotechnologies Corporation, Adienne SA, Allovir Inc. Amgen Inc. Astellas Pharma US, bluebird bio inc. Bristol Myers Squibb Co. CareDx, CSL Behring, CytoSen Therapeutics Inc. Daiichi Sankyo Co. Ltd. Eurofins Viracor, ExcellThera, Fate Therapeutics, Gamida-Cell Ltd. Genentech Inc, Gilead, GlaxoSmithKline, Incyte Corporation, Janssen/Johnson & Johnson, Jasper Therapeutics, Jazz Pharmaceuticals Inc. Karyopharm Therapeutics, Kiadis Pharma, Kite, a Gilead Company, Kyowa Kirin, Magenta Therapeutics, Medac GmbH, Merck & Co. Millennium, the Takeda Oncology Co. Miltenyi Biotec Inc. MorphoSys, Novartis Pharmaceuticals Corporation, Omeros Corporation, Oncopeptides Inc. Orca Biosystems Inc. Pfizer Inc. Pharmacyclics LLC, Sanofi Genzyme, Seagen Inc. Stemcyte, Takeda Pharmaceuticals, Tscan, Vertex, Vor Biopharma, and Xenikos BV. Funding Information: The CIBMTR is supported primarily by grants from the National Institutes of Health National Cancer Institute (NCI) Public Health Service (U24CA076518), the National Heart, Lung and Blood Institute, and the National Institute of Allergy and Infectious Diseases; NCI (U24CA233032), Health Resources and Services Administration (HHSH250201700006C), the Office of Naval Research (N00014-20-1-2705 and N00014-20-1-2832). Support is also provided by Be the Match Foundation, the Medical College of Wisconsin, the National Marrow Donor Program, and from the following commercial entities: AbbVie, Accenture, Actinium Pharmaceuticals Inc., Adaptive Biotechnologies Corporation, Adienne SA, Allovir Inc., Amgen Inc., Astellas Pharma US, bluebird bio inc., Bristol Myers Squibb Co., CareDx, CSL Behring, CytoSen Therapeutics Inc., Daiichi Sankyo Co. Ltd., Eurofins Viracor, ExcellThera, Fate Therapeutics, Gamida-Cell Ltd., Genentech Inc, Gilead, GlaxoSmithKline, Incyte Corporation, Janssen/Johnson & Johnson, Jasper Therapeutics, Jazz Pharmaceuticals Inc., Karyopharm Therapeutics, Kiadis Pharma, Kite, a Gilead Company, Kyowa Kirin, Magenta Therapeutics, Medac GmbH, Merck & Co., Millennium, the Takeda Oncology Co., Miltenyi Biotec Inc., MorphoSys, Novartis Pharmaceuticals Corporation, Omeros Corporation, Oncopeptides Inc., Orca Biosystems Inc., Pfizer Inc., Pharmacyclics LLC, Sanofi Genzyme, Seagen Inc., Stemcyte, Takeda Pharmaceuticals, Tscan, Vertex, Vor Biopharma, and Xenikos BV. Publisher Copyright: {\textcopyright} 2022 American Society of Hematology",
year = "2022",
month = mar,
day = "3",
doi = "10.1182/blood.2021013289",
language = "English (US)",
volume = "139",
pages = "1330--1339",
journal = "Blood",
issn = "0006-4971",
publisher = "American Society of Hematology",
number = "9",
}