Early failure is still a poor prognostic factor in patients with relapsed or refractory large B-cell lymphoma in the era of CAR T-cell therapy.
J Clin Exp Hematop
; 64(2): 107-118, 2024.
Article
en En
| MEDLINE
| ID: mdl-38925972
ABSTRACT
Patients with refractory or relapsed (R/R) large B-cell lymphoma (LBCL) refractory to first-line chemotherapy or with early relapse have poor outcomes. While chimeric antigen receptor (CAR) T-cell therapy has impressive efficacy after two or more lines of chemotherapy, it's still uncertain if these outcomes remain consistent in the context of third-line CAR T-cell therapy. We conducted a retrospective study of 107 R/R LBCL patients. Patients with relapse 12 months or more after their first-line chemoimmunotherapy (late failure n = 25) had significantly longer overall survival (OS) than patients with refractory disease or relapse within 12 months (early failure n = 82) (median OS not achieved vs. 18.4 months; P < 0.001). Among patients who proceeded to autologous hematopoietic stem-cell transplantation (auto-HSCT), those with late failure had significantly longer event-free survival (EFS) than those with early failure (median EFS 26.9 vs. 3.1 months; P = 0.012). However, no significant difference in EFS was detected among patients who underwent CAR T-cell therapy (median EFS not reached vs. 11.8; P = 0.091). Cox regression with restricted cubic spline demonstrated that timing of relapse had significant impact on EFS in patients with auto-HSCT but not in patients with CAR T-cell therapy. Of patients who were scheduled for CAR T-cell therapy, those with late failure were significantly more likely to receive CAR T-cell therapy than those with early failure (90% vs. 57%; P = 0.008). In conclusion, patients with early failure still experienced poor outcomes after the approval of third-line CAR T-cell therapy.
Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Inmunoterapia Adoptiva
/
Linfoma de Células B Grandes Difuso
Idioma:
En
Revista:
J Clin Exp Hematop
/
J. clin. exp. hematop. (Online)
/
Journal of clinical and experimental hematopathology (Online)
Asunto de la revista:
HEMATOLOGIA
/
PATOLOGIA
Año:
2024
Tipo del documento:
Article