Allogeneic transplantation after immunotherapy for relapsed/refractory non-Hodgkin lymphoma: a comparison with a historical cohort

• Published in: Cytotherapy (Oxford, England) Vol. 26; no. 10; pp. 1163 - 1169
• Main Authors: Mariotti, Jacopo, Zucchinetti, Cristina, Giordano, Laura, De Philippis, Chiara, Mannina, Daniele, Sarina, Barbara, Taurino, Daniela, Carbon, Rachele, Santoro, Armando, Bramanti, Stefania
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.10.2024
• Subjects: Adult; Advanced Basic Science; Aged; Female; glofitamab; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation - methods; Humans; Immunotherapy - methods; Immunotherapy, Adoptive - methods; loncastuximab; Lymphoma, Non-Hodgkin - mortality; Lymphoma, Non-Hodgkin - therapy; Male; Middle Aged; Neoplasm Recurrence, Local - therapy; non-Hodgkin lymphoma; Other; programmed cell death protein 1 inhibitor; Recurrence; Retrospective Studies; Salvage Therapy - methods; transplantation; Transplantation, Homologous - methods; glofitamab; non-Hodgkin lymphoma; loncastuximab; transplantation; programmed cell death protein 1 inhibitor
• ISSN: 1465-3249; 1477-2566; 1477-2566
• DOI: 10.1016/j.jcyt.2024.05.002

New immunotherapy drugs, such as bispecific T-cell engager antibodies, checkpoint inhibitors and antibody–drug conjugates, are commonly used as salvage therapy for patients with non-Hodgkin lymphoma relapsing after chimeric antigen receptor (CAR) T-cell therapy. Nevertheless, their potential long-term effects on the outcome of allogeneic stem cell transplantation (Allo-SCT) are not well known. We retrospectively analyzed the outcomes of 27 relapsed/refractory non-Hodgkin lymphoma patients receiving Allo-SCT after immunotherapy in the pre-CAR T-cell therapy era and compared them with a historical cohort of 28 subjects undergoing Allo-SCT after conventional therapy. The two cohorts had similar outcomes in terms of graft-versus-host disease/relapse-free survival (4 years, 59% versus 46%), overall survival (4 years, 77% versus 44%), non-relapse mortality (4 years, 19% versus 22%) and acute (6 months, 15% versus 21%) and chronic (4 years, 18% versus 24%) graft-versus-host disease. Of note, the cumulative incidence of relapse was lower after immunotherapy (4 years, 4% versus 14%), although significance was not reached. The cumulative incidence of cytomegalovirus and fungal infection did not differ among the two cohorts. Consolidation with Allo-SCT is a safe and curative option for patients achieving disease response after new immunotherapy drugs that could represent a desirable salvage strategy for patients relapsing after CAR T-cell therapy. [Display omitted]