Autologous stem cell transplantation as bridging therapy followed by CD19 CAR-T cells in relapsed-refractory large B cell lymphoma.

Eugenio Galli, Federica Sora', Stefan Hohaus, Silvia Bellesi, Francesco Autore, Elisabetta Metafuni, Idanna Innocenti, John Marra, Alberto Fresa, Maria Assunta Limongiello, Sabrina Giammarco, Lucia Leccisotti, Andrea Guarneri, Patrizia Chiusolo, Luca Laurenti, Luciana Teofili, Nicola Piccirillo, Andrea Bacigalupo, Simona Sica

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Peripheral blood autologous stem cell transplantation (PBSCT) is considered the standard consolidation treatment for refractory aggressive large B cell lymphoma (LBCL) in first complete remission (CR) [1], and it may also have a role for patients with chemosensitive LBCL without CR [2]. Additionally, PBSCT alone was retrospectively associated with better outcomes compared to chimeric antigen receptor T cell therapy (CAR-T) in patients with LBCL with partial remission (PR) after salvage therapy [3], despite ZUMA-7 trial may have recently suggested differently [4]. Nowadays, third-line standard treatment is based on CAR-T cells. The addition of a bridging therapy may be necessary to contain the disease progression. As lower disease burden assessed before CAR-T cells infusion is associated with better outcomes [5] and prior studies have established that tandem autologous–allogeneic stem cell transplantation is feasible and provides satisfactory outcomes in patients with high-risk LBCL [6, 7], we reasoned that in patients receiving CAR-T cells, PBSCT might provide better disease debulking than conventional bridging regimens and thereby lead to greater efficacy of subsequent CAR-T cell therapy. In our clinical practice, we have proposed the use of autologous PBSCT as a bridging therapy prior to infusion of CAR-T cells to six patients with very high-risk NHL and available frozen autologous stem cells. To date, there are no published data on the use of PBSCT as a bridge to CAR-T cell therapy. All patients described have provided informed consent to non-interventional anonymized use of their clinical data.
Lingua originaleEnglish
pagine (da-a)837-839
RivistaBone Marrow Transplantation
Stato di pubblicazionePubblicato - 2022


  • CAR-T and lymphoma


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