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

The median time from lymphocyte collection to the start of conditioning for PBSCT was six days (Range 1–44 days). The main toxicities related to PBSCT were grade 3 infections and grade 4 cytopenias. No unexpected toxicities were observed. Patients were discharged at a median of 12 days (Range 11–15 days). Median engraftment of neutrophils was at 10 days, and median engraftment of platelets was at 11.5 days. CAR-T cell manufacturing took a median of 31 days and proceeded during PBSCT. At the time that frozen CAR-T product had arrived at our center, five of the six patients had already been discharged following completion of PBSCT. Median time from arrival of CAR-T cells at our center to start of lymphocyte depletion was 22 days (Range 12–46 days). At that point, three out of six patients had attained CR or PR, two patients remained stable and one patient had progressed. At the time of lymphocyte depletion for CAR-T, all patients showed an absolute neutrophil count (ANC) above 500/μL, and three patients had an ANC above 1000/μL. Median time from PBSCT to CAR-T cell infusion was 50 days (Range 48–74 days).