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3434 Efficacy and Safety of Autologous Stem Cell Transplantation Combined with Chimeric Antigen Receptor T-Cell Therapy in the Treatment of Refractory/Relapsed B-Cell Lymphoma

Program: Oral and Poster Abstracts
Session: 703. Cellular Immunotherapies: Basic and Translational: Poster II
Hematology Disease Topics & Pathways:
Combination therapy, Therapies
Sunday, December 10, 2023, 6:00 PM-8:00 PM

Lixia Ma1*, Xiaoyan Ke2,3* and Kai HU1*

1Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, China
2Peking University Third Hospital, Beijing, China
3Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, China


Autologous hematopoietic stem cell transplantation (ASCT) and chimeric antigen receptor T‐cell therapy (CART) are salvage therapies that are utilised for the treatment of relapsed or refractory (R/R) B-cell lymphoma. However, whether the combination therapy of ASCT and CART (ASCT‐CART) can improve the survival of R/R B-cell lymphoma remains unknown.


The objective is to explore the effectiveness and safety of ASCT‐CART in the treatment of refractory/relapsed B-cell lymphoma and compare the effects of disease status before ASCT-CART on patient survival.


From October 2019 to October 2022, 49 patients with R/R B-cell lymphoma tract were enrolled. The male/female ratio was 1.2:1, with a median age of 40 years (range, 16-69 years).The diagnosis included diffuse large B-cell lymphoma (DLBCL) (n=31), High-grade B-cell lymphoma(n=8), Primary mediastinal B-cell lymphoma (PMBCL) (n=7), Burkitt lymphoma (BL) (n=2) and Richer (n=1). Among them , stage III-IV accounted for 43/49 (87.8%) and GCB subtype 22/49 (44.9%),and received a median of 7 cycles(3-14)of prior treatment, previous radiotherapy was 8/49 (16.3%), and previous other target CART patients were 20/49 (40.8%).The disease status of patients before ASCT-CART was 23 patients in complete remission, 17 patients in partial remission, 3 patients with stable disease, and 6 patients with progressive disease.Patients were treated with BEAM and fludarabine before ASCT. Autologous stem cells were transfused with D0, and the median number of CD34+ cells was 4.14*106/kg(range, 0.7-12.99*106/kg). CART cells were transfused on D1, and the median infusion of CART cells was 2.06*106/kg(range, 0.07-9.5*106/kg).


In efficacy assessment at 3 months after treatment, the objective response rate (ORR) was 40/49(81.6%), and the complete response rate (CRR) was 38/49 (77.6%).After a median follow-up of 23.1 months, the median overall survival (OS) was not reached, with 1-year OS being 81.6%, 2-year OS being 76%, and 3-year OS being 72.3%(Figure 1A). Median progression-free survival (PFS) was not reached, with 1-year PFS at 73.5%, 2-year FFS at 70.5%, and 3-year FFS at 66.6%(Figure 1B) . Neutrophil and platelet engraftment in all cases on median days 16 (range 10-62 days) and 16 (range 7-52), respectively.Grade 3 or higher cytokine release syndrome (≥grade 3 CRS) and immune efector cell-associated neurologic toxicity syndrome (≥grade 3 ICANS) events occurred in 22.4%(11/49) and 4.1%(2/49)of the patients, respectively.In the 3-month efficacy evaluation of CR group before ASCT-CART treatment, ORR was 21/23(91.3%) and CRR was 20/23(87.0%). ORR and CRR were 19/26(73.1%) and 18/26 (69.2%) in patients who did not reach CR before ASCT-CART treatment.The 3-year OS and 3-year PFS were 91.3% and 82.6% in CR group before ASCT-CART treatment(Figure 1C,D). The 3-year OS and 3-year PFS in the non-CR group were 58.6% and 54.6% respectively(Figure 1C,D). Patients in CR group before ASCT-CART treatment had significantly prolonged OS and PFS (P=0.0243) and OS (P= 0.0720).


The ASCT-CART therapy could enhance its the remission rate and long-term efficacy in the treatment of advanced relapsed/refractory B-cell lymphoma with controllable safety. Patients who were in remission before ASCT-CART therapy achieved a longer term remission after ASCT-CART cell therapy.

Disclosures: No relevant conflicts of interest to declare.

*signifies non-member of ASH