Prompt Autologous Hematopoietic Stem Cell Transplant in Patients With Large B-Cell Lymphoma Is Associated With Lower Rates of Progression of Disease Prior to Transplant.

INTRODUCTION

To ensure response is preserved, it is common practice to continue chemotherapy in patients with large B-cell lymphoma (LBCL) awaiting autologous hematopoietic stem cell transplant (HSCT), even after they have achieved complete or partial response (CR/PR).

METHODS

We conducted a retrospective chart review of patients with LBCL evaluated at our institution between 2011 and 2022 to examine the effect of delay of transplant and continuation of chemotherapy past CR/PR on progression of disease (PD) prior to transplant. The association of PD prior to transplant with delayed transplant and additional chemotherapy was modeled using logistic regression.

RESULTS

Out of the 87 patients included, 74 (85%) had relapsed/refractory LBCL. Transplant was delayed in 20 (23%) patients, and 22 (25%) patients received chemotherapy after CR/PR. Delay of transplant was associated with higher odds of PD prior to transplant (odds ratio [OR] = 4.0, = 0.034), as was additional chemotherapy use after CR/PR (OR = 2.2, = 0.09).

CONCLUSION

Proceeding to autologous HSCT as soon as adequate response is achieved in LBLC was associated with a lower likelihood of progression of disease prior to transplant regardless of additional chemotherapy receipt.

TRIAL REGISTRATION

The authors have confirmed that clinical trial registration is not needed for this submission.