Authors
Anna Ossami Saidy, Ariane Boumendil, Peter Dreger, Federico Stella, Ron Ram, Nicolaus Kröger, Luca Castagna, Thomas Pabst, Gerald G Wulf, Alejandro Martin Garcia-Sancho, Carlos Solano, Matthias Stelljes, Hans C Reinhardt, Edouard Forcade, Malte von Bonin, Inken Hilgendorf, Joaquin Martínez López, Wolfgang Bethge, Ali Bazarbachi, Anna Sureda, Norbert Schmitz, Bertram Glass, GOCART initiative, Lymphoma Working Party (LWP) of the EBMT
Published in
Bone marrow transplantation. Jun 19, 2026. Epub Jun 19, 2026.
Abstract
The International Prognostic Index (IPI) is an essential prognostic tool for patients with large B-cell lymphoma (LBCL). To compare outcomes after chimeric antigen receptor T-cell (CART) therapy and allogeneic stem cell transplantation (alloSCT) in relation to IPI risk factors, we analyzed 515 LBCL patients receiving CART (n = 303) or alloSCT (n = 212) as ≥third-line treatment, registered with EBMT (2016-2021). Patients treated with CART were older (median 62.4 vs 51.1 years), had higher IPI scores (48.2% vs 20.8% high/high-intermediate risk), and a higher incidence of refractory disease (84.1% vs 34.6%). At 24 months, overall survival (OS) was 49% vs 41%, progression-free survival (PFS) was 37% vs 32%, relapse-incidence (RI) was 56% vs 38%, and non-relapse-mortality (NRM) was 7% vs 30%, respectively. In multivariate analysis, CART therapy showed superior OS primarily due to significantly lower NRM, while RI was higher. The survival benefit of CART was significant in patients with low/low-intermediate IPI (OS HR 0.43, 95% CI 0.31-0.60), but not observed in high-risk patients. Elevated LDH eliminated the PFS advantage of CART over alloSCT. Poor outcomes after CART in patients with high-risk disease support early preparation for alloSCT for eligible patients.
PMID:
42321403
Bibliographic data and abstract were imported from PubMed on 20 Jun 2026.
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