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The impact of IPI risk factors on CAR T-cell therapy or allogeneic stem cell transplantation for treatment of relapsed or refractory large B-cell lymphoma (LBCL) - PubMed

5 hours ago
  • #CAR T-cell therapy
  • #large B-cell lymphoma
  • #allogeneic stem cell transplantation
  • The study analyzed 515 patients with relapsed/refractory large B-cell lymphoma (LBCL) who received CAR T-cell therapy or allogeneic stem cell transplantation (alloSCT) as third-line or later treatment.
  • CAR T-cell therapy patients were older, had higher IPI scores, and more refractory disease compared to alloSCT patients.
  • At 24 months, CAR T-cell therapy showed higher overall survival (49% vs 41%) and progression-free survival (37% vs 32%), but higher relapse incidence (56% vs 38%) and lower non-relapse mortality (7% vs 30%) than alloSCT.
  • CAR T-cell therapy provided superior overall survival primarily due to lower non-relapse mortality, though with higher relapse incidence.
  • The survival benefit of CAR T-cell therapy was significant in patients with low/low-intermediate IPI risk but not observed in high-risk patients.
  • Elevated LDH levels eliminated the progression-free survival advantage of CAR T-cell therapy over alloSCT.
  • Poor outcomes after CAR T-cell therapy in high-risk patients support early consideration of alloSCT for eligible individuals.