Scholarlink

<p>High-dose chemotherapy with autologous stem cell transplantation (ASCT) is an option for patients aged ≥ 65&#xa0;years with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL). Few data are available to select patients suitable for chimeric antigen receptor T-cell (CAR-T) therapy or bispecific antibodies. We retrospectively analyzed the risk factors for poor outcomes for 451 Japanese patients aged ≥ 65&#xa0;years with R/R DLBCL who received ASCT at either second complete remission or first partial remission (<i>n</i> = 336 and 115, respectively) between 2011 and 2022. CAR-T became commercially available in Japan in March 2019, and the annual number of ASCTs for older patients with R/R DLBCL increased significantly until 2018. However, the number of ASCT cases plateaued in 2018. Multivariate Cox regression analysis identified ≤ 24&#xa0;months from diagnosis to ASCT (hazard ratio [HR], 1.497) and performance status &gt; 0 at ASCT (HR, 1.460) as independent predictors of overall survival (OS) and an association with late recurrence. The 3-year OS rates were 73.4% (95% confidence interval [CI], 65.8%–79.6%) in patients with &gt; 24&#xa0;months from diagnosis to ASCT and 58.6% (95% CI, 51.2%–65.2%) in those with ≤ 24&#xa0;months from diagnosis to ASCT. The 3-year OS rates were 69.4% (95% CI, 62.5%–75.2%) in patients with performance status (PS) = 0 and 60.6% (95% CI, 62.5%–70.4%) in those with PS &gt; 0. CAR-T therapy or bispecific antibodies may be used initially instead of ASCT for early relapsed and refractory patients. However, ASCT remains beneficial for older chemo-sensitive patients with late recurrence and good performance status.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Autologous stem cell transplantation from 2011 to 2022 in Japanese patients aged ≥ 65 years with relapsed or refractory diffuse large B-cell lymphoma

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年7月23日

查看全文
  • Satoshi Yamasaki,
  • Shohei Mizuno,
  • Kota Yoshifuji,
  • Eri Matsuki,
  • Masashi Sawa,
  • Takashi Akasaka,
  • Naoyuki Uchida,
  • Hitoji Uchiyama,
  • Keisuke Kataoka,
  • Nobuhiro Hiramoto,
  • Yoshinobu Kanda,
  • Kazuya Ishiwata,
  • Toshio Wakayama,
  • Takahiro Fukuda,
  • Makoto Yoshimitsu,
  • Makoto Onizuka,
  • Marie Ohbiki,
  • Yoshiko Atsuta,
  • Ritsuro Suzuki,
  • Shinichi Kako

摘要

High-dose chemotherapy with autologous stem cell transplantation (ASCT) is an option for patients aged ≥ 65 years with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL). Few data are available to select patients suitable for chimeric antigen receptor T-cell (CAR-T) therapy or bispecific antibodies. We retrospectively analyzed the risk factors for poor outcomes for 451 Japanese patients aged ≥ 65 years with R/R DLBCL who received ASCT at either second complete remission or first partial remission (n = 336 and 115, respectively) between 2011 and 2022. CAR-T became commercially available in Japan in March 2019, and the annual number of ASCTs for older patients with R/R DLBCL increased significantly until 2018. However, the number of ASCT cases plateaued in 2018. Multivariate Cox regression analysis identified ≤ 24 months from diagnosis to ASCT (hazard ratio [HR], 1.497) and performance status > 0 at ASCT (HR, 1.460) as independent predictors of overall survival (OS) and an association with late recurrence. The 3-year OS rates were 73.4% (95% confidence interval [CI], 65.8%–79.6%) in patients with > 24 months from diagnosis to ASCT and 58.6% (95% CI, 51.2%–65.2%) in those with ≤ 24 months from diagnosis to ASCT. The 3-year OS rates were 69.4% (95% CI, 62.5%–75.2%) in patients with performance status (PS) = 0 and 60.6% (95% CI, 62.5%–70.4%) in those with PS > 0. CAR-T therapy or bispecific antibodies may be used initially instead of ASCT for early relapsed and refractory patients. However, ASCT remains beneficial for older chemo-sensitive patients with late recurrence and good performance status.