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Multicenter Study
. 2025 Jul 8;9(13):3281-3292.
doi: 10.1182/bloodadvances.2024015415.

Autologous stem cell transplantation for relapsed/refractory large B-cell lymphoma: a multicenter GETH-TC/GELTAMO study

Leyre Bento  1 , Antonio Gutiérrez  1 , Carmen Martínez  2 , María Consejo Ortí Verdet  3 , Marina Sorribes  4 , Ana Carolina Caballero  4 , Marta Peña  5 , Ariadna Pérez  6 , Ana Jiménez-Ubieto  7 , Lucía Medina  7 , Mariana Bastos-Oreiro  8 , Paula Fernández Caldas-González  8 , Belén Navarro  9 , Isabel Salcedo  9 , Pau Abrisqueta  10 , Ignacio Español  11 , Javier Cornago  12 , Fernando Martín-Moro  13 , Lucía García  14 , Pilar Gómez  15 , María Rosario Varela  16 , María Puente  17 , Joud Zanabili  18 , Teresa Zudaire  19 , Izaskun Zeberio  20 , Raquel Del Campo  21 , Leslie González  22 , Pedro González  23 , Cristina Blázquez  24 , Jordina Rovira  25 , Marta Sitges  26 , Mireia Franch-Sarto  27 , Almudena Cabero  28 , Alberto Mussetti  5 , Juan Montoro  3 , Antonia Sampol  1 , Anna Sureda  5 , Dolores Caballero  28 , Alejandro Martín García-Sancho  28
Affiliations
Multicenter Study

Autologous stem cell transplantation for relapsed/refractory large B-cell lymphoma: a multicenter GETH-TC/GELTAMO study

Leyre Bento et al. Blood Adv. .

Abstract

We performed a retrospective multicenter study including 791 patients with relapsed/refractory (R/R) large B-cell lymphoma (LBCL) who underwent autologous stem cell transplantation (ASCT). After a median follow-up of 74 months from infusion, 65% were alive and 84% free of disease. Progression-free survival (PFS) and overall survival (OS) at 6 years were 51% and 63%, respectively. Non-relapse mortality at 1 year was 9%. Age >60 years at ASCT (hazard ratio [HR], 1.31; 95% CI, 1.06-1.62; P = .011), ASCT as ≥3rd line (HR, 1.81; 95% CI, 1.42-2.31; P < .001), and partial response (PR) vs complete response (CR) at ASCT (HR, 1.46; 95% CI. 1.18-1.81; P < .001) were independent variables influencing PFS. Age >60 years at ASCT (HR, 1.62; 95% CI, 1.24-2.12; P < .001), time period before 1 November 2012 (HR, 1.40; 95% CI, 1.07-1.83; P = .014), ASCT as ≥3rd line (HR, 1.77; 95% CI, 1.32-2.37; P < .001), PR vs CR (HR, 1.58; 95% CI, 1.22-2.05; P < .001), and stable disease vs CR pre-ASCT (HR, 3.41; 95% CI, 1.81-6.45; P < .001) were variables associated with worse OS. Refractory/early relapse did not significantly influence survival (6-year PFS and OS in patients with refractory, early, and late relapse were 54% and 64%, 46% and 62%, and 49% and 63%, respectively). To our knowledge, this is the largest series analyzing the efficacy of ASCT in patients with R/R LBCL after rituximab-containing frontline therapy. Our results indicate that ASCT is a curative option for patients with chemosensitive disease.

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Conflict of interest statement

Conflict of interest disclosure: The authors declare no competing financial interests.

A complete list of the members of the Grupo Español de Trasplante y Terapia Celular and Grupo Español de Linfoma y Trasplante Autólogo appears in “Appendix.”

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Survival, NRM and relapse/progression in the overall series. PFS (A), OS (B), NRM (C), and CI relapse (D) in the overall series.
Figure 2.
Figure 2.
Survival according to disease status at ASCT in global series. PFS (A) and OS (B) according to disease status at ASCT in global series.
Figure 3.
Figure 3.
Survival depending on response to frontline treatment. PFS (A) and OS (B) depending on response to frontline treatment.
Figure 4.
Figure 4.
Survival in subgroup of patients with primary refractory disease or early relapse. PFS (A) and OS (B) according to disease status at ASCT in subgroup of patients with primary refractory disease or early relapse.
Figure 5.
Figure 5.
Survival in patients with high-grade BCL. PFS (A) and OS (B) in patients with high-grade BCL (double hit and NOS subtype).
See this image and copyright information in PMC

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