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Autologous stem cell transplantation for relapsed/refractory large B-cell lymphoma: a multicenter GETH-TC/GELTAMO study.

2025-07-08, Blood Advances (10.1182/bloodadvances.2024015415) (online)
Anna Sureda, Juan Montoro, Alejandro Martín García-Sancho, Pedro Antonio González-Sierra, Mariana Bastos-Oreiro, Marta Peña, Antonia Sampol, Ana Carolina Caballero Gonzalez, Alberto Mussetti, Leyre Bento, Carmen Martínez, María Consejo Ortí Verdet, Marina Sorribes, Ariadna Pérez, Ana Jiménez-Ubieto, Lucía Medina, Paula Fernández Caldas-González, Belén Navarro, Isabel Salcedo, Pau Abrisqueta, Ignacio Español, Javier Cornago, Fernando Martín-Moro, Lucía García, Pilar Gómez, María Rosario Varela, María Puente, Joud Zanabili, Teresa Zudaire, Izaskun Zeberio, Raquel Del Campo, Leslie González, Pedro González, Cristina Blázquez, Jordina Rovira, Marta Sitges, Mireia Franch-Sarto, Almudena Cabero, and Dolores Caballero (?)
We performed a retrospective multicenter study including 791 patients with relapsed/refractory (R/R) large B-cell lymphoma (LBCL) who underwent autologous stem cell transplantation (ASCT). After a median follow-up of 74 months from infusion, 65% were alive and 84% free of disease. Progression-free survival (PFS) and overall survival (OS) at 6 years were 51% and 63%, respectively. Non-relapse mortality at 1 year was 9%. Age >60 years at ASCT (hazard ratio [HR], 1.31; 95% CI, 1.06-1.62; P = .011), ASCT as ≥3rd line (HR, 1.81; 95% CI, 1.42-2.31; P < .001), and partial response (PR) vs complete response (CR) at ASCT (HR, 1.46; 95% CI. 1.18-1.81; P < .001) were independent variables influencing PFS. Age >60 years at ASCT (HR, 1.62; 95% CI, 1.24-2.12; P < .001), time period before 1 November 2012 (HR, 1.40; 95% CI, 1.07-1.83; P = .014), ASCT as ≥3rd line (HR, 1.77; 95% CI, 1.32-2.37; P < .001), PR vs CR (HR, 1.58; 95% CI, 1.22-2.05; P < .001), and stable disease vs CR pre-ASCT (HR, 3.41; 95% CI, 1.81-6.45; P < .001) were variables associated with worse OS. Refractory/early relapse did not significantly influence survival (6-year PFS and OS in patients with refractory, early, and late relapse were 54% and 64%, 46% and 62%, and 49% and 63%, respectively). To our knowledge, this is the largest series analyzing the efficacy of ASCT in patients with R/R LBCL after rituximab-containing frontline therapy. Our results indicate that ASCT is a curative option for patients with chemosensitive disease.
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