ASCO Expert on the Analysis of Autologous Stem Cell Transplant in Relapsed DLBCL

July 15, 2020

Nirav Niranjan Shah, MD, discussed the use of autologous transplantation in patients with relapsed, chemosensitive DLBCL after the introduction of CAR T-cells.

In a data analysis using the Center of International Bone Marrow Transplant Registry (CI-BMTR), investigators evaluated whether the use of autologous transplantation in patients with relapsed, chemosensitive DLBCL should remain the standard of care.

The results of the analysis, presented at the 2020 American Society of Clinical Oncology (ASCO) Virtual Scientific Meeting, suggested that autologous stem cell transplant should remain the standard of care in this patient population, even with the introduction of CAR T-cells.

In an interview with CancerNetwork®, Nirav Niranjan Shah, MD, of the Medical College of Wisconsin, spoke about data analysis and the key findings from the study.

Transcription:

So, this was a data analysis using the CI-BMTR registry, so the Center of International Bone Marrow Transplant Registry. And so, it's a retrospective data set that allows us to look at patients who have undergone autologous stem cell transplant. And we specifically looked at a particular patient population, those who have diffuse large B-cell lymphoma, and then we stratified it further looking for a very particular population. Those who at the time of relapse and time of autologous transplant, had chemosensitive disease, but also had a PET scan that showed that they were in a partial response before the autologous stem cell transplant.

So, we wanted to look at this population of patients who went into their transplant with a partial response, really to understand: is there a role for autologous stem cell transplant for this patient population in the CAR T-cell era? What we found through the registries was that the number of autologous stem cell transplants done for diffuse large B-cell lymphoma had decreased 45% from 2017 to 2018. This made us think that there might be some patients like this who had a PET-CT partial response that didn't go to auto transplant, but probably got CAR T-cell therapy instead. And so, we wanted to see what the outcomes for autologous transplant look like. What we found in our study was that the 5 year progression-free survival, whether you relapsed early within 12 months of diagnosis or relapsed late, the progression-free survival was 41% at 5 years for both cohorts, and we were encouraged by this number and it does show that autologous transplant does still have a role for patients with chemosensitive relapsed diffuse large B-cell lymphoma, even if they have only a partial response at the time of transplant.