Autologous stem cell transplantation in T-cell/histiocyte-rich large B-cell lymphoma: EBMT Lymphoma Working Party study

Although broadly used, consolidative autologous hematopoietic stem cell transplantation (auto-HCT) for relapsed/refractory (R/R) T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) has never been specifically investigated. Here, we have analyzed outcomes of auto-HCT for THRLBCL compared with diffuse large cell B-cell lymphoma not otherwise specified (DLBCL). Eligible for this retrospective registry study were adult patients with R/R THRLBCL and DLBCL, respectively, who underwent a first auto-HCT in a salvage-sensitive disease status as assessed by positron emission tomography-computed tomography between 2016 and 2021 and were registered with the European Society for Blood and Marrow Transplantation database. The primary end point was progression-free survival (PFS) 2 years after transplantation. A total of 201 patients with THRLBCL and 5543 with DLBCL were included. There were no significant differences in terms of disease status at HCT, pretreatment lines, and interval from diagnosis to transplant between the cohorts, but patients with THRLBCL were significantly younger, contained a higher proportion of men, and had a better performance status. Compared with DLBCL, THRLBCL was associated with significantly better 2-year PFS (78% vs 59%; P < .001) and overall survival (OS, 81% vs 74%; P = .02) because of a significantly lower 2-year relapse incidence (16% vs 35%; P < .001). On multivariate analysis, favorable relapse risk (hazard ratio [HR], 0.46; 95% confidence interval [CI], 0.31-0.7) and PFS (HR, 0.58; 95% CI, 0.41-0.82) of patients with THRLBCL remained significant, whereas OS benefits (HR, 0.78; 95% CI, 0.54-1.12) did not. These results were validated in a propensity score-matched analysis. These data prove auto-HCT as an effective treatment option for salvage-sensitive R/R THRLBCL.

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Journal
Blood Advances
Published
2024-08-30
DOI
https://doi.org/10.1182/bloodadvances.2024013152
Citations
2
Primary Topic
Lymphoma Diagnosis and Treatment
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article
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article

Autologous stem cell transplantation in T-cell/histiocyte-rich large B-cell lymphoma: EBMT Lymphoma Working Party study

Norbert Schmitz, Nicolaas PM Schaap, Adrian Bloor, Matthew Collin et al.
2 citations
Blood Advances
Lymphoma Diagnosis and Treatment
0.85
article

Autologous stem cell transplantation in T-cell/histiocyte-rich large B-cell lymphoma: EBMT Lymphoma Working Party study

Norbert Schmitz, Nicolaas PM Schaap, Adrian Bloor, Matthew Collin, Roland Schroers, Simon Renders, Maud Ngoya, Hervé Finel, Grzegorz Helbig, William Townsend, Urban Novak, Anna Sureda, Hervé Ghesquières, Guido Kobbe, Mahmoud Aljurf, Peter Dreger, Josè Antonio Pérez-Simón, Huynh Anne, Marie-Thérèse Rubio, Bertram Glaß
article en
2 citations

Abstract

Although broadly used, consolidative autologous hematopoietic stem cell transplantation (auto-HCT) for relapsed/refractory (R/R) T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) has never been specifically investigated. Here, we have analyzed outcomes of auto-HCT for THRLBCL compared with diffuse large cell B-cell lymphoma not otherwise specified (DLBCL). Eligible for this retrospective registry study were adult patients with R/R THRLBCL and DLBCL, respectively, who underwent a first auto-HCT in a salvage-sensitive disease status as assessed by positron emission tomography-computed tomography between 2016 and 2021 and were registered with the European Society for Blood and Marrow Transplantation database. The primary end point was progression-free survival (PFS) 2 years after transplantation. A total of 201 patients with THRLBCL and 5543 with DLBCL were included. There were no significant differences in terms of disease status at HCT, pretreatment lines, and interval from diagnosis to transplant between the cohorts, but patients with THRLBCL were significantly younger, contained a higher proportion of men, and had a better performance status. Compared with DLBCL, THRLBCL was associated with significantly better 2-year PFS (78% vs 59%; P < .001) and overall survival (OS, 81% vs 74%; P = .02) because of a significantly lower 2-year relapse incidence (16% vs 35%; P < .001). On multivariate analysis, favorable relapse risk (hazard ratio [HR], 0.46; 95% confidence interval [CI], 0.31-0.7) and PFS (HR, 0.58; 95% CI, 0.41-0.82) of patients with THRLBCL remained significant, whereas OS benefits (HR, 0.78; 95% CI, 0.54-1.12) did not. These results were validated in a propensity score-matched analysis. These data prove auto-HCT as an effective treatment option for salvage-sensitive R/R THRLBCL.

Blood AdvancesVol. 8(21)
Université Claude Bernard Lyon 1 (FR), University of Bern (CH), Radboud University Nijmegen (NL), Medical University of Silesia (PL), Heidelberg University (DE), King Faisal Specialist Hospital & Research Centre (SA), University Hospital of Bern (CH), Royal London Hospital (GB), Freeman Hospital (GB), University Hospital Heidelberg (DE), Radboud University Medical Center (NL), Centre Hospitalier Universitaire de Toulouse (FR), Institut universitaire du cancer de Toulouse Oncopole (FR), Centre Hospitalier Régional et Universitaire de Nancy (FR), Hospices Civils de Lyon (FR), University Hospital Münster (DE), Institut Català d'Oncologia (ES), Universitätsklinikum Knappschaftskrankenhaus Bochum (DE), Hôpital Lyon Sud (FR), The Christie Hospital (GB), Instituto de Biomedicina de Sevilla (ES), The Christie NHS Foundation Trust (GB), Hospital Universitario Virgen del Rocío (ES), Helios Hospital Berlin-Buch (DE), European Society for Blood and Marrow Transplantation (FR), Heinrich Heine University Düsseldorf (DE), University College London (GB), Universidad de Sevilla (ES), Newcastle University (GB), Ruhr University Bochum (DE)
Openalex Percentile: Top 26%
Lymphoma Diagnosis and Treatment
0.85
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