Role of allogeneic hematopoietic cell transplant for relapsed/refractory aggressive B-cell lymphomas in the CART era
Por:
Mussetti, A, Bento, L, Bastos-Oreiro, M, Sansalvador, BR, Albo, C, Bailen, R, Barba, P, Benzaquen, A, Briones, J, Caballero, AC, Campos, A, Espanol, I, Ferra, C, Lopez, SG, Sierra, PAG, Guerra, LM, Hernani, R, Iacoboni, G, Ubieto, AIJ, Kwon, M, Corral, LL, Lopez-Godino, O, Munoz, MCM, Martinez-Cibrian, N, Gomez, JM, Perez-Ortega, L, Ortf, G, Ortiz-Maldonado, V, Pascual, MJ, Perera, M, Perez, A, Reguera, JL, Sanchez, JM, Sanz, J, Torrent, A, Yanez, L, Varela, R, Echechipia, IC, Caballero, D, Sureda, A
Publicada:
14 mar 2023
Ahead of Print:
1 mar 2023
Resumen:
Anti-CD19 chimeric antigen receptor T cells (CART) has rapidly been adopted as the standard third-line therapy to treat aggressive B-cell lymphomas (ABCL) after failure of second-line therapy despite the lack of direct comparisons with allogeneic hematopoietic cell transplantation (alloHCT)-based strategies. Using the Grupo Espanol de Trasplante y Terapia Celular (GETH-TC) registry, we selected patients with the following characteristics: CART or alloHCT performed between 2016 and 2021; >= 18 years old; ABCL diagnosis; >= 2 lines of therapy; and either anti-CD19 CART or alloHCT as therapy at relapse. The analysis included a total of 316 (CART =215, alloHCT = 101) patients. Median follow-up was 15 and 36 months for the CART and alloHCT cohorts, respectively. In the multivariate analysis, CART was confirmed to be similar to alloHCT for the primary study endpoint (progression-free survival) (hazard ratio [HR] 0.92, CI95%:0.56-1.51, p= 0.75). Furthermore, when the analysis was limited to only patients with chemosensitive diseases (complete and partial response) at infusion (CART = 26, alloHCT=93), no differences were reported (progression free survival at month +18:65% versus 55%, p = 0.59). However, CART had lower non-relapse mortality (HR 0.34, 95% CI: 0.13-0.85, p = 0.02). Given the lower toxicity and similar survival outcomes, these results suggest the use of CART before alloHCT. Bone Marrow Transplantation
Filiaciones:
Mussetti, A:
Inst Invest Biomed Bellvitge IDIBELL, Barcelona, Spain
Bento, L:
Hosp Univ Son Espases, Hematol Dept, Palma De Mallorca, Spain
Bastos-Oreiro, M:
Univ Gregorio Maranon, Hosp Gral, Serv Hematol & Hemoterapia, Madrid, Spain
Sansalvador, BR:
Inst Invest Biomed Bellvitge IDIBELL, Barcelona, Spain
Albo, C:
Complejo Hosp Pontevedra, Pontevedra, Spain
Bailen, R:
Gregorio Maranon Hlth Res Inst, Madrid, Spain
Barba, P:
Univ Hosp Vall Hebron, Vall Hebron Inst Oncol VHIO, Dept Hematol, Barcelona, Spain
Benzaquen, A:
Hosp Clin Univ Valencia, Hematol Dept, Inst Invest Sanitaria INCLIVA, Valencia, Spain
Briones, J:
Hosp Santa Creu I St Pau, Dept Hematol, Barcelona, Spain
Caballero, AC:
Hosp Santa Creu I St Pau, Dept Hematol, Barcelona, Spain
Campos, A:
Inst Portugues Oncol Porto, Serv Transplantacao Medula Ossea, Porto, Portugal
Espanol, I:
Hosp Clin Univ Virgen de la Arrixaca, Hematol Dept, Murcia, Spain
Ferra, C:
Inst Catala Oncol H Germans Trias I Pujol, Badalona, Spain
Lopez, SG:
Hosp SAS Jerez, Jerez de la Frontera, Spain
Sierra, PAG:
Univ Granada, Dept Hematol, Complejo Hosp, Granada, Spain
Guerra, LM:
Hosp Univ Gran Canaria Doctor Negrin, Hematol Dept, Las Palmas Gran Canaria, Spain
Hernani, R:
Hosp Clin Univ Valencia, Hematol Dept, Inst Invest Sanitaria INCLIVA, Valencia, Spain
Iacoboni, G:
Univ Hosp Vall Hebron, Vall Hebron Inst Oncol VHIO, Dept Hematol, Barcelona, WA, Spain
Ubieto, AIJ:
Univ Complutense Madrid, Hosp Univ 12 Octubre, Ctr Invest Biomed Red Canc CIBERONC, CNIO, Madrid, Spain
Kwon, M:
Hosp Gen Univ Gregorio Maranon, Inst Hlth Res Gregorio Maranon, Dept Hematol, Madrid, Spain
Corral, LL:
Hosp Clin Univ Salamanca CAUSA IBSAL, Dept Hematol, Salamanca, Spain
Lopez-Godino, O:
Hosp Univ Morales Meseguer, Hematol Dept, Murcia, Spain
Munoz, MCM:
Hosp Clin Barcelona, Clin Inst Hematol & Oncol ICMHO, Hematopoiet Transplantat Unit, IDIBAPS, Barcelona, Spain
Hosp Clin Barcelona, Clin Inst Hematol & Oncol ICMHO, Hematol Dept, IDIBAPS, Barcelona, Spain
Martinez-Cibrian, N:
Hosp Clin Barcelona, Barcelona, Spain
Gomez, JM:
Hosp Univ & Politecn La Fe, Hematol Dept, Valencia, Spain
Perez-Ortega, L:
Hosp Univ Virgen del Rocio, Seville, Spain
Ortf, G:
HU Vall dHebron, Barcelona, Spain
Ortiz-Maldonado, V:
Hosp Clin Barcelona, Dept Hematol, Barcelona, Spain
Pascual, MJ:
Hosp Reg Univ Malaga, Dept Hematol, Malaga, Spain
Perera, M:
Hosp Univ Gran Canaria Dr Negrin, Hematol, Las Palmas Gran Canaria, Spain
Perez, A:
Hosp Infantil Univ Nino Jesus, Hematol, Madrid, Spain
Reguera, JL:
Hosp Univ Virgen Del Rocio, Inst Biomed Sevilla, Seville, Spain
Sanchez, JM:
Hosp Univ 12 Octubre, Dept Hematol, Madrid, Spain
Sanz, J:
Hosp Univ La Fe, Avinguda Fernando Abril Martorell, Valencia, Spain
Torrent, A:
Univ Autonoma Barcelona, ICO Hosp Germans Trias I Pujol, Josep Carreras Res Inst, Hematol Dept, Badalona, Spain
Yanez, L:
Hosp Univ Marques Valdecilla, Hematol Dept, Santander, Spain
Varela, R:
Hosp Univ A Coruna, La Coruna, Spain
Echechipia, IC:
Hosp Univ Donostia, San Sebastian, Spain
Caballero, D:
Hosp Univ Salamanca HUS IBSAL, Dept Hematol, Salamanca, Spain
CIBERONC, Salamanca, Spain
Sureda, A:
Hosp Duran I Reynals, Inst Catala Oncol, Dept Clin Hematol, IDIBELL, Barcelona, Spain
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