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Role of allogeneic hematopoietic cell transplant for relapsed/refractory aggressive B-cell lymphomas in the CART era

Abstract: 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 Español 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 chemo-sensitive 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

 Fuente: Bone Marrow Transplantation, 2023, 58(6), 673-679 - (CORRIGENTUM), 2023, 58(6), 673-679

 Editorial: Nature Publishing Group

 Año de publicación: 2023

 Nº de páginas: 7

 Tipo de publicación: Artículo de Revista

 DOI: 10.1038/s41409-023-01949-x

 ISSN: 0268-3369,1476-5365

 Url de la publicación: https://doi.org/ 10.1038/s41409-023-01949-x

Autoría

MUSSETTI, ALBERTO

BENTO, LEYRE

BASTOS-OREIRO, MARIANA

RIUS-SANSALVADOR, BLANCA

ALBO, CARMEN

BAILEN, REBECA

BARBA, PERE

BENZAQUÉN, ANA

BRIONES, JAVIER

CAROLINA CABALLERO, ANA

CAMPOS, ANTÓNIO

ESPAÑOL, IGNACIO

FERRA, CHRISTELLE

GARZÓN LÓPEZ, SEBASTIÁN

GONZÁLEZ SIERRA, PEDRO ANTONIO

GUERRA, LUISA MARIA

HERNANI, RAFAEL

IACOBONI, GLORIA

JIMÉNEZ-UBIETO, ANA