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Allogeneic transplantation after immunotherapy for relapsed/refractory non-Hodgkin lymphoma: a comparison with a historical cohort. | LitMetric

AI Article Synopsis

  • New immunotherapy treatments like bispecific T-cell engagers and checkpoint inhibitors are often used for patients with non-Hodgkin lymphoma who relapse after CAR T-cell therapy, but their long-term effects on stem cell transplants are unclear.
  • A study compared outcomes of 27 patients who received allogeneic stem cell transplants (Allo-SCT) after immunotherapy to 28 patients who underwent Allo-SCT after standard treatment, finding similar survival rates and complications between the two groups.
  • The study suggests that Allo-SCT is a safe and effective option for patients who respond to immunotherapy, potentially serving as a solid treatment strategy after CAR T-cell therapy failures.*

Article Abstract

Background Aims: New immunotherapy drugs, such as bispecific T-cell engager antibodies, checkpoint inhibitors and antibody-drug conjugates, are commonly used as salvage therapy for patients with non-Hodgkin lymphoma relapsing after chimeric antigen receptor (CAR) T-cell therapy. Nevertheless, their potential long-term effects on the outcome of allogeneic stem cell transplantation (Allo-SCT) are not well known.

Methods: We retrospectively analyzed the outcomes of 27 relapsed/refractory non-Hodgkin lymphoma patients receiving Allo-SCT after immunotherapy in the pre-CAR T-cell therapy era and compared them with a historical cohort of 28 subjects undergoing Allo-SCT after conventional therapy.

Results: The two cohorts had similar outcomes in terms of graft-versus-host disease/relapse-free survival (4 years, 59% versus 46%), overall survival (4 years, 77% versus 44%), non-relapse mortality (4 years, 19% versus 22%) and acute (6 months, 15% versus 21%) and chronic (4 years, 18% versus 24%) graft-versus-host disease. Of note, the cumulative incidence of relapse was lower after immunotherapy (4 years, 4% versus 14%), although significance was not reached. The cumulative incidence of cytomegalovirus and fungal infection did not differ among the two cohorts.

Conclusions: Consolidation with Allo-SCT is a safe and curative option for patients achieving disease response after new immunotherapy drugs that could represent a desirable salvage strategy for patients relapsing after CAR T-cell therapy.

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Source
http://dx.doi.org/10.1016/j.jcyt.2024.05.002DOI Listing

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