Hematopoietic stem cell transplantation for DLBCL: a report from the European Society for Blood and Marrow Transplantation on more than 40,000 patients over 32 years

Autologous(auto-) and allogeneic(allo-) hematopoietic stem cell transplantation (HSCT) are key treatments for relapsed/refractory diffuse large B-cell lymphoma (DLBCL), although their roles are challenged by CAR-T-cells and other immunotherapies. We examined the transplantation trends and outcomes f...

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Main Authors: Berning, Philipp (Author) , Fekom, Mathilde (Author) , Ngoya, Maud (Author) , Goldstone, Anthony H. (Author) , Dreger, Peter (Author) , Montoto, Silvia (Author) , Finel, Hervé (Author) , Shumilov, Evgenii (Author) , Chevallier, Patrice (Author) , Blaise, Didier (Author) , Strüßmann, Tim (Author) , Carpenter, Ben (Author) , Forcade, Edouard (Author) , Castilla-Llorente, Cristina (Author) , Trneny, Marek (Author) , Ghesquieres, Hervé (Author) , Capria, Saveria (Author) , Thieblemont, Catherine (Author) , Blau, Igor-Wolfgang (Author) , Meijer, Ellen (Author) , Broers, Annoek E. C. (Author) , Huynh, Anne (Author) , Caillot, Denis (Author) , Rösler, Wolf (Author) , Nguyen Quoc, Stephanie (Author) , Bittenbring, Jörg (Author) , Nagler, Arnon (Author) , Galimard, Jacques-Emmanuel (Author) , Glass, Bertram (Author) , Sureda, Anna (Author) , Schmitz, Norbert (Author)
Format: Article (Journal)
Language:English
Published: 05 July 2024
In: Blood cancer journal
Year: 2024, Volume: 14, Pages: 1-13
ISSN:2044-5385
DOI:10.1038/s41408-024-01085-9
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1038/s41408-024-01085-9
Verlag, kostenfrei, Volltext: https://www.nature.com/articles/s41408-024-01085-9
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Author Notes:Philipp Berning, Mathilde Fekom, Maud Ngoya, Anthony H. Goldstone, Peter Dreger, Silvia Montoto, Hervé Finel, Evgenii Shumilov, Patrice Chevallier, Didier Blaise, Tim Strüssmann, Ben Carpenter, Edouard Forcade, Cristina Castilla-Llorente, Marek Trneny, Hervé Ghesquieres, Saveria Capria, Catherine Thieblemont, Igor Wolfgang Blau, Ellen Meijer, Annoek E. C. Broers, Anne Huynh, Denis Caillot, Wolf Rösler, Stephanie Nguyen Quoc, Jörg Bittenbring, Arnon Nagler, Jacques-Emmanuel Galimard, Bertram Glass, Anna Sureda and Norbert Schmitz

MARC

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520 |a Autologous(auto-) and allogeneic(allo-) hematopoietic stem cell transplantation (HSCT) are key treatments for relapsed/refractory diffuse large B-cell lymphoma (DLBCL), although their roles are challenged by CAR-T-cells and other immunotherapies. We examined the transplantation trends and outcomes for DLBCL patients undergoing auto-/allo-HSCT between 1990 and 2021 reported to EBMT. Over this period, 41,148 patients underwent auto-HSCT, peaking at 1911 cases in 2016, while allo-HSCT saw a maximum of 294 cases in 2018. The recent decline in transplants corresponds to increased CAR-T treatments (1117 cases in 2021). Median age for auto-HSCT rose from 42 (1990-1994) to 58 years (2015-2021), with peripheral blood becoming the primary stem cell source post-1994. Allo-HSCT median age increased from 36 (1990-1994) to 54 (2015-2021) years, with mobilized blood as the primary source post-1998 and reduced intensity conditioning post-2000. Unrelated and mismatched allo-HSCT accounted for 50% and 19% of allo-HSCT in 2015-2021. Three-year overall survival (OS) after auto-HSCT improved from 56% (1990-1994) to 70% (2015-2021), p < 0.001, with a decrease in relapse incidence (RI) from 49% to 38%, while non-relapse mortality (NRM) remained unchanged (4%). After allo-HSCT, 3-year-OS increased from 33% (1990-1999) to 46% (2015-2021) (p < 0.001); 3-year RI remained at 39% and 1-year-NRM decreased to 19% (p < 0.001). Our data reflect advancements over 32 years and >40,000 transplants, providing insights for evaluating emerging DLBCL therapies. 
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