Long-term follow-up of autologous hematopoietic cell transplantation for diffuse large B cell lymphoma in the rituximab era: real‑world data from a retrospective single‑center analysis.

Autologous stem cell transplantation (ASCT) is the standard treatment for diffuse large B-cell lymphoma (DLBCL) in certain circumstances. However, the risk factors for ASCT outcomes remain elusive. We analyzed data from 141 patients with DLBCL who underwent first ASCT in the past decade, including 19 with pre-existing autoimmune disorders (ADs). We focus on the clinical characteristics and their potential predictive roles for the long-term transplant prognosis. With a median follow-up of 50 months (interquartile range, 26.3 to 128), progression-free survival (PFS) and overall survival (OS) at 3 years were 82.8% and 90.2%, respectively. Deaths after ASCT were predominantly caused by lymphoma relapse (73.3%). Notably, ADs history was independently associated with an increased risk of all-cause mortality (Hazard Ratio [HR]: 8.38, P = 0.014) and lymphoma relapse (HR: 6.67, P = 0.026). Furthermore, disease status before ASCT, COO subtypes, lactate dehydrogenase level at diagnosis and relapse after chemotherapy were also identified as prognostic factors for both PFS and OS. These findings demonstrate ASCT as a viable treatment option for eligible patients with high-risk DLBCL and highlight the need for increased attention to lymphoma with pre-ADs.