Predictors of long‐term survival outcomes following receipt of autologous stem cell transplantation for patients with diffuse large/high grade B cell lymphoma

Introduction: Per the CORAL study, response to salvage immunochemotherapy (IC) for patients (pts) diagnosed with relapsed/refractory (R/R) diffuse large B cell lymphoma (DLBCL) and high grade B cell lymphoma (HGBL) was predicted by time to relapse, International Prognostic Index (IPI) score and prior receipt of rituximab. However, it is unclear if these risk factors or others predict for survival in R/R DLBCL/HGBL pts with chemosensitive disease following salvage IC who receive high dose chemotherapy/autologous stem cell transplantation (HDC/ASCT), an understanding of which may inform future efforts to risk-stratify R/R DLBCL/HGBL pts who are candidates for this therapy. Methods: Included pts were age ≤75 years who received HDC/ASCT at the University of Pennsylvania between 3/1/13 and 3/1/21. All pts received prior rituximab and anthracycline. Response to salvage IC was determined by PET-CT. Freedom from treatment failure (FFTF) was defined as the interval between receipt of HDC/ASCT and proven/suspected relapse of DLBCL/HGBL or last follow-up (f/u) in remission. Overall survival was defined as the interval between receipt of HDC/ASCT or CART19 and death or last f/u while alive. Data were censored on 3/1/23. Results: Characteristics at the time of start of salvage IC as well as treatment characteristics for 100 consecutive HDC/ASCT pts are listed in the Table. With a median length of f/u of 62.7 months (mo), the estimated (est) rates of freedom from treatment failure (FFTF) and overall survival (OS) at 60 mo were 57% (95% confidence interval [CI]: 46%–67%) and 71% (95% CI: 60%–80%). On univariate analysis, only history of indolent lymphoma was associated with a lower risk of TF at 60 mo (hazard ratio 0.22, 95% CI: 0.07–0.73, P = 0.01). As seen in the Figure, est rates of FFTF at 60 mo did not differ by time to diagnosis of R/R disease, primary refractory disease status, IPI score or response to salvage IC. Keyword: Aggressive B-cell non-Hodgkin lymphoma Conflicts of interests pertinent to the abstract. D. J. Landsburg Consultant or advisory role: Morphosys, Epizyme, Calithera, ADC Therapeutics, Karyopharm Research funding: Curis, Calithera, Epizyme Educational grants: Novartis S. D. Nasta Research funding: Pharmacyclics, Roche, Rafael, FortySeven J. Svoboda Consultant or advisory role: SEAGEN, Pharmacyclics, Incyte, Genmab, BMS, Atara, Astra Zeneca, Adaptive, ADCT Research funding: TG, SEAGEN, Pharmacyclics, Merck, Incyte, BMS, Astra Zeneca S. J. Schuster Consultant or advisory role: Novartis, Regeneron, Nordic, Morphosys, MustangBio, Incyte, Genentech/Roche, Janssen, Legend Biotech, Loxo, Acerta, BiGene, Celgene, Nanovecter Research funding: Novartis, Pharmacyclics, Merck, DTRM, Juno Therapeutics, Abbvie, Adaptive Biotechnologies, Incyte, Genentech/Roche, Celgene, TG Therapeutics J. N. Gerson Consultant or advisory role: Genentech, Abbvie Research funding: Loxo E. A. Chong Consultant or advisory role: Juno/BMS, Novartis, Beigene, KITE, Tessa S. K. Barta Consultant or advisory role: Daiichi Sankyo, Kyowa Kirin, Janssen, Affimed Honoraria: Acrotech, Seagen, Kyowa Kirin A. L. Garfall Consultant or advisory role: Jannsen, GlaxoSmithKline, Bristol-Myers Squibb Research funding: Novartis, Tmunity Therapeutics, Janssen, Crispr Therapeutics E. A. Stadtmauer Research funding: BMS, Celgene, Abbvie, Sorrento D. L. Porter Consultant or advisory role: Novartis, Kite/Gilead, Incyte, Janssen, Jazz, DeCart, BMS, Bluebird Bio, Angiocrine, Mirror Biologics, Capstan Therapeutics, Instill Bio Research funding: Novartis