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
(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.
(Less)
- author
- 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.
- organization
- publishing date
- 2022
- 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, >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.</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}}, }