Efficacy and Safety of Polatuzumab Vedotin in Combination with Rituximab Plus Bendamustine in Patients with Relapsed/Refractory Diffuse Large B-Cell Lymphoma: A Single Center Analysis of Pola Compassionate Use Program (CUP) in China

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Objective: To investigate the efficacy and safety of Polatuzumab vedotin+rituximab±bendamustine (Pola-(B)R) in relapse/refractory diffuse large B cell lymphoma (R/RDLBCL) patients. Methods: The clinical data of 13 patients enrolled in Chinese Pola compassionate use program (CUP) in department of Hematology-Oncology of Chongqing University Cancer Hospital from October 2021 to July 2022 were collected. There were 5 males and 8 females, and the median age was 58 years (ranged 45-76 years)of the patients,10 cases received Pola-BR and the other 3 received Pola-R. Before the use of Pola, all patients have received at least 2-8 lines Immunochemotherapy and median treatments were 5 lines. 10 patients (77%) were classified as medium and high-risk group according to IPI or aaIPI Prognostic Scoring. 11 patients (85%) had stage III~IV disease, 8 patients (62%) were Non-GCB types, 7 patients(54%) with Ki-67 over 80% in pathological IHC and 2 patients (15%) were diagnosed as double-expression lymphoma . At data cut off , the objective response rate(ORR) of 13 patients was 46.2%(6/13), no patients reached complete remission(CR) , 5 patients (38.4%) could not complete whole 6 cycles of pola combined treatment for intolerable adverse reactions and 4 patient(30.8%)died due to progression disease(PD). The most common hematological toxicity events were neutrophil count decreased,thrombocytopenia and anemia, with 3-4 level occurrence rate was 38.4%,30.8% and 15.4%. The most common non-hematological toxicity events were peripheral neuropathy, pneumonia and fatigue. 2 patients had tumor lysis syndrome and 1 patient had hemophagocytic syndrome. Conclusions: Polatuzumab is widely used all over the world, even for heavily treated Chinese R/R DLBCL patients, the Pola-(B)R regimen still achieves remission and safety are comprehensive controllable.