Autologous Stem Cell Transplantation for Relapsed/Refractory Large B Cell Lymphoma: Multicenter GETH-TC/GELTAMO Study

Blood Adv. 2025 Mar 31:bloodadvances.2024015415. doi: 10.1182/bloodadvances.2024015415. Online ahead of print.

ABSTRACT

We performed a retrospective multicenter study including 791 patients with relapsed/refractory (R/R) large B cell lymphoma (LBCL) who underwent ASCT from 2010-2021. All the patients received rituximab and anthracycline-based frontline therapy. After a median follow-up of 74 months (95%CI 68-81) from infusion, 65% of the patients were alive and 84% of them free of disease. Progression-free survival (PFS) and overall survival (OS) at 6 years were 51% (95%CI 47-54) and 63% (95%CI 60-67), respectively. Non-relapse mortality (NRM) at 1 year was 9% (95%CI 7-11). Age >60 years at ASCT [HR 1.31 (95%CI 1.06-1.62), p=0.011], ASCT as ≥3rd line [HR 1.81 (95%CI 1.42-2.31), p<0.001] and partial response (PR) versus complete response (CR) at ASCT [HR 1.46 (95%CI 1.18-1.81), p<0.001] were the independent variables influencing PFS. Age >60 years at ASCT [HR 1.62 (95%CI 1.24-2.12), p<0.001], time period before first of November 2012 [HR 1.40 (95%CI 1.07-1.83), p=0.014], ASCT as ≥3rd line [HR 1.77 (95%CI 1.32-2.37), p<0.001], PR versus CR [HR 1.58 (95%CI 1.22-2.05), p<0.001] and stable disease (SD) versus CR pre-ASCT [HR 3.41 (95%CI 1.81-6.45), p<0.001] were the variables associated with worse OS. Refractory or early relapse did not significantly influence survival (6y-PFS and OS in patients with refractory, early and late relapse was 54% and 64%; 46% and 62% and 49% and 63%, respectively). To our knowledge, this is the largest series analyzing the efficacy of ASCT in patients with R/R LBCL after rituximab-containing frontline therapy. Our results indicate that ASCT is a curative option for patients with chemosensitive disease.

PMID:40163764 | DOI:10.1182/bloodadvances.2024015415