异基因 SCT 与 tisagenlecleucel 在具有不良预后因素的 R/R LBCL 患者中的结局比较

This study investigated the efficacy of tisagenlecleucel (tisa-cel) and allogeneic hematopoietic stem cell transplantation (allo-SCT) for patients with relapsed and/or refractory (r/r) large B-cell lymphoma (LBCL) with poor prognostic factors, defined as performance status (PS) 2, multiple extranodal lesions (EN), chemorefractory disease, or higher lactate dehydrogenase (LDH).

Overall, the allo-SCT group demonstrated worse progression-free survival (PFS), higher non-relapse mortality, and a similar relapse/progression rate.

Notably, the tisa-cel group showed better PFS than the allo-SCT group among patients with chemorefractory disease (3. 2 vs. 2. 0 months, p = 0. 092) or higher LDH (4. 0 vs. 2. 0 months, p = 0. 018), whereas PFS in the two cellular therapy groups was similar among those with PS 2 or multiple EN. Survival time after relapse post-cellular therapy in patients with poor prognostic factors was 1. 6 with allo-SCT and 4. 6 months with tisa-cel.

These findings were confirmed in a propensity score matching cohort.

In conclusion, tisa-cel resulted in better survival than allo-SCT in patients with poor prognostic factors.

However, patients who relapsed post-cellular therapy had dismal outcomes regardless of therapy.

Further strategies are warranted to improve outcomes in these patients.