Citations 2
Autologous Transplant or CAR‐T as Consolidation Options in MYC Rearranged Large B‐Cell Lymphoma Patients in Remission After Salvage Treatments
Furqan, Fateeha , Ahn, Kwang Woo , Kaur, Manmeet , Patel, Jinalben , Ansell, Stephen M. , Awan, Farrukh T. , Baird, John H. , Farooq, Umar , Fung, Henry C., Khurana, Arushi , Lekakis, Lazaros J. , Lutfi, Forat , McCarty, John M. , Mukherjee, Akash , Nath, Rajneesh , Winter, Allison , Sauter, Craig S. , Herrera, Alex F. , Smith, Melody , Ansell, Stephen M , Baird, John , Khurana, Arushi , Winter, Allison , Shadman, Mazyar , Herrera, Alex F , Awan, Farrukh T , Smith, Melody , Bezerra, Evandro D. , Farooq, Umar, Romancik, Jason T. , Schuster, Stephen J. , Smith, Melody , Turtle, Cameron J. , Shadman, Mazyar , Hamadani, Mehdi
American Journal of Hematology | April 15, 2025 | Volume: 100 | Issue: 7 | Pages: 1152-1162
ABSTRACTAlthough recent studies have demonstrated the efficacy of chimeric antigen receptor T‐cell (CAR‐T) therapy in relapsed large B‐cell lymphoma (LBCL) with MYC rearrangement (R‐MYC), the data comparing CAR‐T to autologous hematopoietic cell transplant (auto‐HCT) in such patients who achieve a complete or partial response (CR/PR) after salvage therapies are limited. We compared the clinical outcomes of patients with R‐MYC LBCL (including double and triple hit lymphomas) who underwent CAR‐T or auto‐HCT after achieving a CR/PR with salvage therapies using the Center for International Blood & Marrow Transplant Research registry. Among the 252 patients (auto‐HCT = 98, CAR‐T = 154), relative to auto‐HCT, CAR‐T was associated with significantly lower overall survival (OS) (Hazard Ratio [HR] 2.09, 95% CI 1.38–3.15, p < 0.001) on multivariate analysis. There were no differences in progression‐free survival (PFS) (HR 1.21, 95% CI 0.81–1.8 p = 0.36), risk of relapse (HR 1.1, 95% CI 0.71–1.69 p = 0.68), nonrelapse mortality (NRM) (HR 1.74, 95% CI 0.64–4.7 p = 0.28) while the post‐relapse survival was longer in auto‐HCT relative to CAR‐T (HR 1.93, 95% CI 1.21–3.06 p = 0.01). On propensity score matched analysis accounting for differences in characteristics across the two cohorts, we detected no significant differences in OS (HR 1.72, 95% CI 0.92–3.21 p = 0.09), PFS (HR 1.04, 95% CI 0.64–1.68 p = 0.88), NRM (HR 1.22, 95% CI 0.35–4.2 p = 0.76), relapse (HR = 0.93, 95% CI 0.54–1.6 p = 0.8) and post‐relapse survival (HR 2.25, 95% CI 0.98–5.17, p = 0.06). These data, although retrospective, support consideration for auto‐HCT in patients with R‐MYC LBCL who achieve a CR/PR after salvage therapies, particularly in regions with no or limited access to CAR‐T.
Increasing use of allogeneic hematopoietic cell transplantation in patients aged 70 years and older in the United States
Muffly, Lori , Pasquini, Marcelo C. , Martens, Michael J. , Brazauskas, Ruta , Zhu, Xiaochun , Adekola, Kehinde , Aljurf, Mahmoud , Ballen, Karen K. , Baron, Frédéric , Beitinjaneh, Amer , Cahn, Jean‐Yves, Carabasi, Mathew, Chen, Yi‐Bin , Ciurea, Stefan O. , Copelan, Edward A. , D’Souza, Anita , Edwards, John , Foran, James M. , Freytes, César O. , Fung, Henry C., Hashmi, Shahrukh K. , Hildebrandt, Gerhard , Ho, Vincent T. , Jakubowski, Ann A. , Luskin, Marlise R. , Martino, Rodrigo , Olin, Rebecca L. , Olsson, Richard F. , Pawarode, Attaphol , Peres, Edward, Rezvani, Andrew R. , Rizzieri, David A. , Schouten, Harry C. , Sabloff, Mitchell , Seftel, Matthew D. , Seo, Sachiko , Sorror, Mohamed L. , Wirk, Baldeep , Wood, William A. , Bajel, Ashish R. , Battiwalla, Minoo , Cahn, Jean‐Yves , Chhabra, Saurabh , Gale, Robert Peter , Giralt, Sergio , Lazarus, Hillard M. , Luskin, Marlise R , Maziarz, Richard Thomas , McCarthy, Philip L. , Nishihori, Taiga , Savani, Bipin N. , Szer, Jeff , Artz, Andrew , D'Souza, Anita , Olsson, Richard F , Martino, Rodrigo , Muffly, Lori , Sabloff, Mitchell , Martens, Michael J , Sorror, Mohamed , Wood, William A
Blood | July 3, 2017 | Volume: 130 | Issue: 9 | Pages: 1156-1164
Key Points Over the last decade, allogeneic HCT has been increasingly administered in the United States to adults aged 70 and older with hematologic malignancies. Allogeneic transplant outcomes were reasonable; high comorbidity and ablative conditioning regimens were associated with inferior outcomes.