Allogeneic transplant and CAR-T therapy after autologous transplant failure in DLBCL: a noncomparative cohort analysis.
Allogeneic transplant and CAR-T therapy after autologous transplant failure in DLBCL: a noncomparative cohort analysis.
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DOI：
10.1182/bloodadvances.2021005788
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发表时间：
2022-01-25
期刊：
影响因子：
7.5
通讯作者：
Locke FL
中科院分区：
文献类型：
--
作者：
Hamadani M;Gopal AK;Pasquini M;Kim S;Qiu X;Ahmed S;Lazaryan A;Bhatt VR;Daly A;Lulla P;Ciurea S;Gauthier J;Agrawal V;Grover NS;Lekakis L;Modi D;Dahi PB;Herr MM;Johnson PC;Hashmi H;Hematti P;Locke FL
CIBMTR预后评分可预测既往autoHCT失败后接受axicabtagene ciloleucel治疗的DLBCL患者的PFS和OS。CIBMTR高/极高风险评分标志着一个不良风险队列，其中需要新的免疫治疗或复发预防方法。同种异体移植（alloHCT）和嵌合抗原受体修饰（CAR）-T细胞疗法是自体（auto）HCT后复发的弥漫性大B细胞淋巴瘤（DLBCL）的潜在治疗选择。尽管国际血液和骨髓移植研究中心（CIBMTR）预后模型可以预测autoHCT失败后DLBCL中alloHCT的结局，但在类似患者人群中CAR-T治疗的相应模型不可用。在这项非比较性登记研究分析中，我们报告了2012年至2019年期间在既往auto-HCT失败后接受降低强度alloHCT或CAR-T治疗的DLBCL患者（≥18岁）的结局，并将CIBMTR预后模型应用于CAR-T受体。共纳入584例患者。autoHCT失败后，CAR-T治疗的1年复发率、非复发死亡率、总生存率（OS）和无进展生存率分别为39.5%、4.8%、73.4%和55.7%。alloHCT队列的相应发生率分别为26.2%、20.0%、65.6%和53.8%。根据CIBMTR预后评分将alloHCT接受者分为低、中、高/极高风险组，其1年OS分别为73.3%、59.9%和46.3%（P = .002）。低、中、高/极高风险CAR-T患者的相应比率分别为88.4%、76.4%和52.8%（P < .001）。该登记研究分析表明，CAR-T和alloHCT均可为既往autoHCT后复发的DLBCL患者亚组提供持久缓解。简单的CIBMTR预后评分可用于识别两种手术后治疗失败的高风险患者。在这些高危患者中，有必要评估细胞免疫治疗后的新复发缓解策略。
CIBMTR prognostic score predicts PFS and OS of patients with DLBCL receiving axicabtagene ciloleucel treatment after a prior autoHCT failure. CIBMTR high/very high-risk score marks an adverse risk cohort where novel immunotherapy or relapse prevention approaches are warranted. Allogeneic transplant (alloHCT) and chimeric antigen receptor modified (CAR)-T cell therapy are potentially cuarative options of diffuse large B-cell lymphoma (DLBCL) relapsing after an autologous (auto)HCT. Although the Center for International Blood and Marrow Transplant Research (CIBMTR) prognostic model can predict outcomes of alloHCT in DLBCL after autoHCT failure, corresponding models of CAR-T treatment in similar patient populations are not available. In this noncomparative registry analysis, we report outcomes of patients with DLBCL (≥18 years) undergoing a reduced intensity alloHCT or CAR-T therapy with axicabtagene ciloleucel during 2012 to 2019 after a prior auto-HCT failure and apply the CIBMTR prognostic model to CAR-T recipients. A total of 584 patients were included. The 1-year relapse, nonrelapse mortality, overall survival (OS), and progression-free survival for CAR-T treatment after autoHCT failure were 39.5%, 4.8%, 73.4%, and 55.7%, respectively. The corresponding rates in the alloHCT cohort were 26.2%, 20.0%, 65.6%, and 53.8%, respectively. The 1-year OS of alloHCT recipients classified as low-, intermediate- and high/very high-risk groups according to the CIBMTR prognostic score was 73.3%, 59.9%, and 46.3%, respectively (P = .002). The corresponding rates for low-, intermediate-, and high/very high-risk CAR-T patients were 88.4%, 76.4%, and 52.8%, respectively (P < .001). This registry analysis shows that both CAR-T and alloHCT can provide durable remissions in a subset of patients with DLBCL relapsing after a prior autoHCT. The simple CIBMTR prognostic score can be used to identify patients at high risk of treatment failure after either procedure. Evaluation of novel relapse mitigations strategies after cellular immunotherapies are warranted in these high-risk patients.
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影响因子：
4.3
作者：
Hamadani, Mehdi;Hari, Parameswaran N.;Zhang, Ying;Carreras, Jeanette;Akpek, Goerguen;Aljurf, Mahmoud D.;Ayala, Ernesto;Bachanova, Veronika;Chen, Andy I.;Chen, Yi-Bin;Costa, Luciano J.;Fenske, Timothy S.;Freytes, Cesar O.;Ganguly, Siddhartha;Hertzberg, Mark S.;Holmberg, Leona A.;Inwards, David J.;Kamble, Rammurti T.;Kanfer, Edward J.;Lazarus, Hillard M.;Marks, David I.;Nishihori, Taiga;Olsson, Richard;Reddy, Nishitha M.;Rizzieri, David A.;Savani, Bipin N.;Solh, Melhem;Vose, Julie M.;Wirk, Baldeep;Maloney, David G.;Smith, Sonali M.;Montoto, Silvia;Saber, Wael
通讯作者：
Saber, Wael
DOI：
10.1056/nejmoa1707447
发表时间：
2017-12-28
期刊：
The New England journal of medicine
影响因子：
--
作者：
Neelapu SS;Locke FL;Bartlett NL;Lekakis LJ;Miklos DB;Jacobson CA;Braunschweig I;Oluwole OO;Siddiqi T;Lin Y;Timmerman JM;Stiff PJ;Friedberg JW;Flinn IW;Goy A;Hill BT;Smith MR;Deol A;Farooq U;McSweeney P;Munoz J;Avivi I;Castro JE;Westin JR;Chavez JC;Ghobadi A;Komanduri KV;Levy R;Jacobsen ED;Witzig TE;Reagan P;Bot A;Rossi J;Navale L;Jiang Y;Aycock J;Elias M;Chang D;Wiezorek J;Go WY
通讯作者：
Go WY
影响因子：
4.3
作者：
Bacigalupo, Andrea;Ballen, Karen;Rizzo, Doug;Giralt, Sergio;Lazarus, Hillard;Ho, Vincent;Apperley, Jane;Slavin, Shimon;Pasquini, Marcelo;Sandmaier, Brenda M.;Barrett, John;Blaise, Didier;Lowski, Robert;Horowitz, Mary
通讯作者：
Horowitz, Mary
DOI：
10.1016/j.bbmt.2009.01.010
发表时间：
2009-05
期刊：
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
影响因子：
--
作者：
Hamadani M;Benson DM Jr;Hofmeister CC;Elder P;Blum W;Porcu P;Garzon R;Blum KA;Lin TS;Marcucci G;Devine SM
通讯作者：
Devine SM
影响因子：
7.5
作者：
Dreger, Peter;Sureda, Anna;Hamadani, Mehdi
通讯作者：
Hamadani, Mehdi