Page 207 - Haematologica May 2022

Letters to the Editor
evaluate for association between disease status at autoHCT (CR vs. PR), baseline covariates, and NRM, relapse, PFS, and OS; covariates are listed in the Online Supplementary Table S1. PR at autoHCT was associated with significantly increased risk of relapse (HR 1.59, 95% CI: 1.13-2.24, P=0.008), inferior PFS (HR 1.46, 95% CI: 1.08-1.97, P=0.01), and OS (HR 1.55, 95% CI: 1.12- 2.15, P=0.009, Online Supplementary Table S2). Causes of death were analyzed for the 144 patients who died. Overall, 61% (n=88) died from DLBCL, whereas the sec- ond leading cause of death was secondary malignancy (10%).
We have found in our registry analysis that autoHCT performed in the 3L+ setting for DLBCL is feasible and effective with a 5-year PFS of 41% and 35% in patients who achieved CR and PR, respectively, prior to autoHCT. Multivariate regression analyses demonstrat- ed that CR at the time of autoHCT was associated with less relapse and improved PFS and OS. These data sug- gest that autoHCT still may play a role in the 3L+ setting in DLBCL for patients who demonstrate an objective response to a second salvage. In fact, a substantial per- centage of 3L+ patients in PR at autoHCT experienced durable disease control. This finding is in keeping with a
Table 1. Baseline characteristics of patients receiving BEAM conditioning regimen and autologous hematopoietic cell transplantation for diffuse large B-cell lymphoma during 2003-2017 (>=three prior lines of treatment)
Number of patients
285
60 (19-80)
154
60 (20-80)
All patients
170 (60)
229 (80) 28 (10) 18 (6) 10 (4)
140 (49) 12 (4)
199 (70) 17 (6)
39 (14) 182 (64)
202 (71) 15 (5)
181 (64) 15 (5)
(5-172)
179 (63) 6 (2)
119 (42) 19 (7)
CR
92 (60)
124 (80) 15 (10) 11 (7) 4 (3)
87 (57) 7 (4)
106 (69) 11 (7)
25 (16) 95 (62)
102 (66) 7 (5)
105 (68) 7 (5)
23 (6-140)
86 (56) 5 (3)
46 (30) 14 (9)
PR
131
Patient age
Median (range), y
≥65y,n(%) 85(30) 46(30) 39(30)
P-value 0.28
0.22
0.97 0.76
0.02
0.66
0.39
0.07 0.22
0.22 0.01 0.02
< 0.001
0.01 0.32
0.61
59 (19-77)
Males
Patient race Caucasian African American Other*
Missing
Karnofsky Performance Score ≥90
Missing
Stage at diagnosis Stage III-IV Missing
LDH
Elevated at diagnosis Missing
Bone marrow involvement at diagnosis No
Missing
Extranodal involvement at diagnosis Yes
Missing
Time from diagnosis to HCT, median (range), mo
Early chemoimmunotherapy failure Yes
Missing
Primary refractory after first line of therapy Yes
Missing
Number of prior lines of therapy 3
78 (60)
105 (80) 13 (10) 7 (5) 6 (5)
53 (40) 5 (4)
93 (71) 6 (5)
14 (11) 87 (66)
100 (76) 8 (6)
76 (58) 8 (6)
17 (5-172)
93 (71) 1 (1)
73 (56) 5 (4)
217
>3 68 28 40
Conditioning regimen BEAM
Rituximab-BEAM
Year of transplant 2003-2007 2008-2012 2013-2017
Median follow-up of survivors (range), mo
227 (80) 58 (20)
98 (34) 99 (35) 88 (31)
72 (4-145)
126 (82) 28 (18)
49 (32) 56 (36) 49 (32)
72 (6-145)
101 (77) 30 (23)
49 (37) 43 (33) 39 (30)
72 (4-143)
126
91
Unless otherwise noted, data are n (%). BEAM: carmustine, etoposide, cytarabine, and melphalan; HCT: hematopoietic stem cell transplantation; DLBCL: diffuse large B-cell lym- phoma; LDH: lactate dehydrogenase; CR: complete remission; PR: partial remission; y:years, mo: months. *Other race: CR: 11 Asian; PR: 5 Asian; 1 American Indian or Alaska Native; 1 Native Hawaiian or Other Pacific Islander.
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