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Allogeneic stem cell transplantation and CAR-T in B-cell Non-Hodgkin Lymphoma: a two-center experience and review of the literature

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Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is still a potentially curative option for B-cell Non-Hodgkin Lymphoma (B-NHL) in the modern immunotherapy era. The objective of this study was to analyze long-term outcomes of patients with B-NHL who received allo-HSCT. We analyzed overall survival (OS), progression-free survival (PFS) and graft versus host disease (GVHD) relapse-free survival (GRFS) in 53 patients undergoing allo-HSCT from two institutions. The median follow-up of the study was 72 months (range 29–115 months). The median number of lines of therapy before allo-HSCT was 3 (range 1–6) and twenty-eight patients (53%) had received a previous autologous transplant. The 3-year PFS, OS and GRFS were 55%, 63%, and 55%, respectively. One-year non-relapse mortality was 26%. Karnofsky Performance Scale < 90 was associated with worse OS in multivariable analysis. A non-comparative analysis of a cohort of 44 patients with similar characteristics who received chimeric antigen receptor T-cell therapy was done, showing a 1-year PFS and OS were 60% and 66%, respectively. Our data shows that allo-HSCT is still a useful option for treating selected patients with R/R B-NHL. Our retrospective analysis and review of the literature demonstrate that allo-HSCT can provide durable remissions in a subset of patients with R/R B-NHL.

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Acknowledgements

The authors thank the staff and faculty of the Marrow Transplantation Program at Huntsman Cancer Institute, University of Utah, Catalan Institute of Oncology and University of Barcelona for tireless work caring for the patients involved in this study.

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This research received no external funding.

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Authors and Affiliations

  1. Transplant and Cellular Therapy Program, Huntsman Cancer Institute, University of Utah, Utah, USA

    Santiago Mercadal, Catherine J. Lee, Silvina M. Odstrcil, Esteban Peña & Daniel R. Couriel

  2. Cellular Therapy and Regenerative Medicine, University of Utah, Utah, USA

    Santiago Mercadal & Daniel R. Couriel

  3. Bone Marrow Transplant and Cellular Therapy Unit, Catalan Institute of Oncology, Hospital Duran I Reynals, Barcelona, Spain

    Alberto Mussetti, Carolina Arevalo & Anna Sureda

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  1. Santiago Mercadal
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  2. Alberto Mussetti
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  3. Catherine J. Lee
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Contributions

SM designed and performed research, analyzed data and wrote the manuscript. DRC designed and reviewed the data and edited the manuscript; CJL, AM, CA, SO, EP and AS reviewed the data and edited the manuscript. All authors approved the final manuscript prior to submission.

Corresponding author

Correspondence to Santiago Mercadal.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Competing interests

SM has received honoraria from Roche, Gilead, Janssen, Servier and research fundings from Roche.

AM has received honoraria from Takeda; consultancy from BMS, Jazz Pharmaceuticals and research funding from Gilead.

CJL has received honoraria for educational activities and/or consultancy and/or participation in advisory boards from Jazz, Incyte, Fresensius Kabi, BMS, Kite, Kadmon, CareDx; has received research funding from Incyte; serves on a trial steering committee for Incyte.

AS has received honoraria from Takeda, BMS/Celgene, MSD, Janssen, Amgen, Novartis, Gilead Kite, Sanofi, Roche, Alexion; consultancy from Takeda, BMS/Celgene, Novartis, Janssen, Gilead, Sanofi; speaker’s Bureau from Takeda and research support from Takeda, BMS/Celgene.

CA, SO, EP and DRC declare no conflicts of interest.

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Mercadal, S., Mussetti, A., Lee, C.J. et al. Allogeneic stem cell transplantation and CAR-T in B-cell Non-Hodgkin Lymphoma: a two-center experience and review of the literature. Ann Hematol 103, 1717–1727 (2024). https://doi.org/10.1007/s00277-024-05677-0

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