Chimeric antigen receptor T‐cell therapy combined with autologous stem cell transplantation improved progression‐free survival of relapsed or refractory diffuse large B‐cell lymphoma patients: A single‐center, retrospective, cohort study

Abstract

Autologous hematopoietic stem cell transplantation (ASCT) and chimeric antigen receptor T-cell therapy (CART) are salvage therapies that are utilised for treatment of relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL). However, whether the combination therapy of ASCT and CART (ASCT-CART) can improve the survival of R/R DLBCL remains unknown. Overall, 67R/R DLBCL patients were included, among which 21 patients underwent ASCT-CART therapy and 46 patients underwent ASCT therapy. The median number of mononuclear cells numbers that were infused in the ASCT-CART and ASCT groups was 4.71×108 /kg and 5.36×108 /kg, respectively (p=0.469). The median number of CD34+ cell numbers that were infused in the ASCT-CART and ASCT groups was 2.41×106 /kg and 3.05×106 /kg, respectively (p=0.663). The median number of CART cells that were infused was 2.63×106 /kg with a median transduction rate of 59.83%. The objective response rates to ASCT-CART and ASCT therapy were 90% and 89%, respectively (p=1.000). However, the ASCT-CART group showed higher complete remission (CR) rates than the ASCT group (71% vs. 33%; p=0.003). The ASCT-CART group demonstrated superior 3year progression-free survival (PFS) (80% vs. 44%; p=0.036) and lower 3year relapse/progression rate (15% vs. 56%; p=0.015) compared to the ASCT group. However, the 3year overall survival results indicated that there were no differences between the two groups (80% vs. 69%; p=0.545). For R/R DLBCL patients, ASCT-CART therapy is associated with higher CR rate, better PFS, and lower relapse/progression rate. These data support that ASCT-CART therapy can be used as a salvage therapy for R/R DLBCL patients.