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Outcomes of relapsed/refractory diffuse large B-cell lymphoma and influence of chimaeric antigen receptor T trial eligibility criteria in second line—A population-based study of 736 patients

Harrysson, Sara ; Eloranta, Sandra ; Ekberg, Sara LU ; Enblad, Gunilla ; El-Galaly, Tarec C. ; Sander, Birgitta ; Sonnevi, Kristina ; Andersson, Per Ola ; Jerkeman, Mats LU and Smedby, Karin E. (2022) In British Journal of Haematology 198(2). p.267-277
Abstract

Several recently published trials investigate novel therapies for relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). To estimate the benefit of these therapies in the real-world setting, comprehensive data on patients treated in clinical routine are needed. We report outcomes for 736 R/R DLBCL patients identified among all curatively treated DLBCL patients in Sweden in the period 2007–2014. Survival and associations with disease characteristics, second-line treatment and fulfilment of chimaeric antigen receptor (CAR) T-cell trial criteria were assessed. Median overall survival (OS) was 6.6 months (≤70 years 9.6 months, >70 years 4.9 months). Early relapse (≤12 months) was strongly associated with selection of less... (More)

Several recently published trials investigate novel therapies for relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). To estimate the benefit of these therapies in the real-world setting, comprehensive data on patients treated in clinical routine are needed. We report outcomes for 736 R/R DLBCL patients identified among all curatively treated DLBCL patients in Sweden in the period 2007–2014. Survival and associations with disease characteristics, second-line treatment and fulfilment of chimaeric antigen receptor (CAR) T-cell trial criteria were assessed. Median overall survival (OS) was 6.6 months (≤70 years 9.6 months, >70 years 4.9 months). Early relapse (≤12 months) was strongly associated with selection of less intensive treatment and poor survival. Among patients of at most 70 years of age, 63% started intensive second-line treatment and 34% received autologous stem cell transplantation (ASCT). Two-year OS among transplanted patients was 56% (early relapse ≤12 months 40%, late relapse >12 months 66%). A minority of patients 76 years (n = 178/506, 35%) fitted CAR T trial criteria. Median progression-free survival (PFS) for patients with early relapse fitting trial criteria was 4.8 months. In conclusion, most R/R DLBCL manifest early and are often ineligible for or cannot complete intensive regimens resulting in dismal survival. Real-world patients eligible for CAR T trials also did poorly, providing a benchmark for efficacy of novel therapies.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
clinical research, epidemiology, non-Hodgkin lymphoma, stem cell transplantation, tumour immunotherapy
in
British Journal of Haematology
volume
198
issue
2
pages
267 - 277
publisher
Wiley-Blackwell
external identifiers
  • scopus:85128848484
  • pmid:35468219
ISSN
0007-1048
DOI
10.1111/bjh.18197
language
English
LU publication?
yes
id
43bd9319-68ae-4360-ab09-2a86f4f35e38
date added to LUP
2022-07-04 14:10:12
date last changed
2024-04-14 15:27:34
@article{43bd9319-68ae-4360-ab09-2a86f4f35e38,
  abstract     = {{<p>Several recently published trials investigate novel therapies for relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). To estimate the benefit of these therapies in the real-world setting, comprehensive data on patients treated in clinical routine are needed. We report outcomes for 736 R/R DLBCL patients identified among all curatively treated DLBCL patients in Sweden in the period 2007–2014. Survival and associations with disease characteristics, second-line treatment and fulfilment of chimaeric antigen receptor (CAR) T-cell trial criteria were assessed. Median overall survival (OS) was 6.6 months (≤70 years 9.6 months, &gt;70 years 4.9 months). Early relapse (≤12 months) was strongly associated with selection of less intensive treatment and poor survival. Among patients of at most 70 years of age, 63% started intensive second-line treatment and 34% received autologous stem cell transplantation (ASCT). Two-year OS among transplanted patients was 56% (early relapse ≤12 months 40%, late relapse &gt;12 months 66%). A minority of patients 76 years (n = 178/506, 35%) fitted CAR T trial criteria. Median progression-free survival (PFS) for patients with early relapse fitting trial criteria was 4.8 months. In conclusion, most R/R DLBCL manifest early and are often ineligible for or cannot complete intensive regimens resulting in dismal survival. Real-world patients eligible for CAR T trials also did poorly, providing a benchmark for efficacy of novel therapies.</p>}},
  author       = {{Harrysson, Sara and Eloranta, Sandra and Ekberg, Sara and Enblad, Gunilla and El-Galaly, Tarec C. and Sander, Birgitta and Sonnevi, Kristina and Andersson, Per Ola and Jerkeman, Mats and Smedby, Karin E.}},
  issn         = {{0007-1048}},
  keywords     = {{clinical research; epidemiology; non-Hodgkin lymphoma; stem cell transplantation; tumour immunotherapy}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{267--277}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{British Journal of Haematology}},
  title        = {{Outcomes of relapsed/refractory diffuse large B-cell lymphoma and influence of chimaeric antigen receptor T trial eligibility criteria in second line—A population-based study of 736 patients}},
  url          = {{http://dx.doi.org/10.1111/bjh.18197}},
  doi          = {{10.1111/bjh.18197}},
  volume       = {{198}},
  year         = {{2022}},
}