Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 May 27;9(10):2500-2510.
doi: 10.1182/bloodadvances.2024014732.

Outcome of high-grade B-cell lymphoma compared with other large B-cell lymphoma after CAR-T rescue: a DESCAR-T LYSA study

Xavier Phina-Ziebin  1 , Emmanuel Bachy  2 , François-Xavier Gros  3 , Roberta Di Blasi  4 , Charles Herbaux  5 , Jacques Olivier Bay  6 , Sylvain Carras  7 , Pierre Bories  8 , Olivier Casasnovas  9 , Fabrice Jardin  10 , Franck Morschhauser  11 , Blandine Guffroy  12 , Mohamad Mohty  13 , Elodie Gat  14 , Julien Calvani  15 , Marie-Cécile Parrens  16 , Elsa Poullot  17 , Alexandra Traverse-Glehen  18 , Louise Roulin  1
Affiliations
Observational Study

Outcome of high-grade B-cell lymphoma compared with other large B-cell lymphoma after CAR-T rescue: a DESCAR-T LYSA study

Xavier Phina-Ziebin et al. Blood Adv. .

Abstract

High-grade B-cell lymphoma (HGBL) with MYC and BCL2 and/or BCL6 rearrangements (double hit [HGBL-DH] or triple hit [HGBL-TH]) or not otherwise specified (HGBL-NOS) are considered to be more aggressive diseases among large B-cell lymphomas (LBCLs). CD19-targeting chimeric antigen receptor (CAR) T cells have changed the prognosis of chemoresistant LBCL. Clinical and pathological data of patients treated for relapsed/refractory LBCL or HGBL in third line or more, all characterized by fluorescence in situ hybridization, were collected from the French DESCAR-T registry. Between January 2018 and November 2022, a total of 228 patients were included across 14 centers, 73 with HGBL (28 HGBL-DH MYC-BCL2, 14 HGBL-TH, 8 HGBL-DH MYC-BCL6, and 23 HGBL-NOS) and 155 with non-HGBL. The median follow-up was 18.5 months (95% confidence interval [CI], 14.3-23.4) from the date of infusion. Progression-free survival and overall survival (OS) were not significantly different between HGBL and non-HGBL, at 3.2 months (95% CI, 2.8-6.0) vs 4.5 months (95% CI, 3.1-8.7; P = .103) and 15.4 months (95% CI, 5.6-32.4) vs 18.3 months (95% CI, 8.5 to not reached), respectively. From the date of eligibility, the median OS was inferior for patients with HGBL-TH/DH MYC-BCL2 at 6.6 months vs 18.5 months for HGBL-NOS vs 13.6 months for HGBL-DH MYC-BCL6 vs 11.8 months for LBCL (P = .037). However, patients who received infusion presented the same outcome. CAR T-cell therapy used in third line or more seems to overcome the poor prognosis of HGBL subtypes, especially in HGBL-TH/DH MYC-BCL2. This observation supports considering the potential benefit of using CAR T cells earlier in disease course.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest disclosure: E.B. received honoraria from Kite, a Gilead Company, and Novartis. F.-X.G. received consulting fees and travel and accommodation expenses from Kite/Gilead and Novartis. R.D.B. received honoraria from Kite, a Gilead Company, and Novartis. O.C. received honoraria from Kite, a Gilead Company. F.J. received honoraria from Gilead. M.M. received honoraria from Kite, a Gilead company, and Novartis. L.R. received travel grants from Kite/Gilead. The remaining authors declare no competing financial interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Flowchart. (1) Population included in the study, that is, with a FISH study allowing for the diagnosis of HGBL or non-HGBL and with a pathology report reviewed within the Lymphopath network. (2) Non-HGBL population of the DESCAR-T cohort not included in the study, compared with the included non-HGBL cohort.
Figure 2.
Figure 2.
Survival data in patients with HGBL and non-HGBL. Survival was evaluated from eligibility (A, OS); from CAR T-cell infusion in the whole group (B, PFS; C, OS); and after infusion in the subgroup of patients who received axi-cel (D, PFS; E, OS). NA, non atteint (not reached).
Figure 3.
Figure 3.
Progression and NRM among patients with HGBL and non-HGBL. NRM, nonrelapse mortality.
Figure 4.
Figure 4.
Survival data in HGBL subgroups. Survival was evaluated from eligibility (A, OS) or from infusion (B, PFS; C, OS). Patients with HGBL-TH or -DH MYC-BCL2 have a significantly lower OS from eligibility (P = .037). NA, non atteint (not reached).
Figure 5.
Figure 5.
Survival data in patients with de novo non-HGBL and non-HGBL transformed from an indolent lymphoma. Survival was evaluated from eligibility (A, OS) or from infusion (B, PFS; OS, C). Patients with de novo non-HGBL have a significantly lower OS from eligibility (P = .004) and from infusion (P = .014). NA, non atteint (not reached).
See this image and copyright information in PMC

References

    1. Landsburg DJ, Ayers EC, Bond DA, et al. Poor outcomes for double-hit lymphoma patients treated with curative-intent second-line immunochemotherapy following failure of intensive front-line immunochemotherapy. Br J Haematol. 2020;189(2):313–317. - PubMed
    1. Oki Y, Noorani M, Lin P, et al. Double hit lymphoma: the MD Anderson Cancer Center clinical experience. Br J Haematol. 2014;166(6):891–901. - PubMed
    1. Sesques P, Johnson NA. Approach to the diagnosis and treatment of high-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements. Blood. 2017;129(3):280–288. - PubMed
    1. Aukema SM, Siebert R, Schuuring E, et al. Double-hit B-cell lymphomas. Blood. 2011;117(8):2319–2331. - PubMed
    1. Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375–2390. - PMC - PubMed

MeSH terms

Substances