The effectiveness of autologous hematopoietic cell transplant (auto-HCT) vs. chimeric antigen receptor T-cell (CAR-T) treatment in patients with diffuse large B-cell lymphoma (DLBCL) who achieve a partial remission (PR) following salvage chemotherapy remained unknown. Therefore, for a study, the researcher identified adult patients with DLBCL who underwent auto-HCT (2013-2019) or CAR-T therapy with axicabtagene ciloleucel (2018-2019) while in a PR by computed tomography or positron emission tomography scan using the Center for International Blood & Marrow Transplant Research registry database. They used univariable and multivariable regression models to assess clinical outcomes between the 2 cohorts after adjusting for important baseline and clinical characteristics.
In the univariable analysis, the 2-year progression-free survival rate (52% vs 42%; P=0.1) and the rate of 100-day nonrelapse mortality (4% vs 2%; P=0.3) 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=0.05) and a superior overall survival (OS) (69% vs Treatment with auto-HCT was linked with a substantially decreased risk of relapse/progression rate (hazard ratio=1.49; P=.01) and a better OS (hazard ratio=1.63; P=0.008) in the multivariable regression analysis. Compared to CAR-T, auto-HCT treatment was related to a reduced rate of recurrence and a higher OS in patients with DLBCL in a PR following salvage therapy. The findings supported the use of auto-HCT in transplant-eligible patients with recurrent DLBCL in PR following salvage treatment.
