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571 Prognostication and Treatment-Related Outcomes in Secondary Central Nervous System Involvement of Large B-Cell Lymphoma (SCNSL): Evidence from a Large International Cohort

Program: Oral and Poster Abstracts
Type: Oral
Session: 626. Aggressive Lymphomas: Clinical and Epidemiological: Challenging Subtypes of Aggressive Lymphomas
Hematology Disease Topics & Pathways:
Research, Epidemiology, Lymphomas, Clinical Research, B Cell lymphoma, Diseases, Real-world evidence, Aggressive lymphoma, Lymphoid Malignancies
Sunday, December 8, 2024: 12:00 PM

Juan Pablo Alderuccio, MD1, Jahanzaib Khwaja2, Sunwoo Han, PhD3*, Paola Ghione, MD, MSEpi4, Imran A. Nizamuddin, MD5, Aditi Saha, MBBS6, Ning Dong, MD7, Yucai Wang, MD, PhD8, Hua-Jay J Cherng9*, Seda S. Tolu, MD10, Nina D. Wagner-Johnston, MD11, Adam J. Olszewski, MD12, Natalie Grover, MD13, Jean L. Koff, MD, MSc14, Amrita Desai, MD, MPH15, Praveen Ramakrishnan Geethakumari, MD, MS16, Tamara K Moyo, MD17*, Jose Sandoval-Sus, MD18, Narendranath Epperla, MD MS19, Danielle S Wallace, MD20, Manali Kamdar, MD, MBBS21*, Alexey Danilov, MD, PhD22, Han W. Tun, MD23, Javier Munoz, MD24*, Mayur S. Narkhede, MD25, Joanna M. Rhodes, MD, MSCE26*, Anca Prica, MD, MSc27*, Andrea Kuhnl28*, Adrian Maraj, FRCPath, MBBChir, MRCP29*, Jessica Okosun, MB BChir PhD30, Jeffery Smith, MBChB BMedSci MRCP FRCPath31*, Wendy Osborne, MD32*, Victoria Calvert33*, Dima el-Sharkawi34*, Ammar Hilali35*, Graham P. Collins36, Kim Linton37*, Nagah Elmusharaf38*, Anna Santarsieri, MBBS39*, Farheen Karim40*, Thomas Ollila, MD12, Sarah Monick, MD41*, Iris Margalit Trutzer, MD, PhD42*, Nilanjan Ghosh43*, Jones Can, MD44*, Amy Ayers, MPH14*, Jacopo Calabrese De Feo, MD45*, John Sharp, MD46, Rachel Treitman, BS47*, Avyakta Kallam, MD48*, Izel Okcu8*, Vismay Deshani49*, Firas Baidoun, MD50*, Chathuri Abeyakoon51*, William Hann52*, Aisling Barrett, FRCPath, MB53*, Brad Kahl, MD54*, Julio C. Chavez, MD55 and Kate Cwynarski, MBBS, PhD, FRCP, FRCPath56*

1Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
2University College London Hospitals NHS Foundation Trust, Sidcup, United Kingdom
3Biostatistics and Bioinformatics Shared Resource, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
4Memorial Sloan Kettering Cancer Center, New York, NY
5Division of Oncology, Washington University School of Medicine, St. Louis, MO
6Department of Hematology/Oncology, Moffitt Cancer Center, West Orange, NJ
7H Lee Moffitt Cancer Center & Research Institute, Tampa
8Division of Hematology, Mayo Clinic, Rochester, MN
9Columbia University Irving Medical Center, New York, NY
10Division of Hematology & Oncology, Columbia University Irving Medical Center, New York City, NY
11Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD
12Brown University, Providence, RI
13University of North Carolina, Chapel Hill, NC
14Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
15Knight Cancer Institute, Oregon Health & Science University, Portland, OR
16Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, Dallas, TX
17Department of Hematologic Oncology and Blood Disorders, Atrium Health Levine Cancer Institute, Charlotte, NC
18Moffitt Cancer Center at Memorial Healthcare System, Pembroke Pines, FL
19Ohio State University, Columbus, OH
20Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY
21Division of Hematology, Hematologic Malignancies and Stem Cell Transplant, University of Colorado Cancer Center, Aurora, CO
22City of Hope Comprehensive Cancer Center, La Canada Flintridge, CA
23Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL
24Mayo Clinic, Phoenix, AZ
25Department of Hematology Oncology, University of Alabama at Birmingham, Birmingham, AL
26Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
27Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre - University Health Network, Toronto, ON, Canada
28King's College Hospital NHS Foundation Trust, London, United Kingdom
29St James Hospital, Dublin, Ireland
30Department of Haemato-Oncology, Barts Hospital, London, ENG, United Kingdom
31The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
32Newcastle Hospitals NHS Trust, Newcastle Upon Tyne, United Kingdom
33Freeman Hospital, Newcastle University, Newcastle, United Kingdom
34The Royal Marsden NHS Foundation Trust, London, United Kingdom
35Royal Marsden NHS Foundation Trust, London, United Kingdom
36Oxford Cancer and Haematology Centre, Oxford, United Kingdom
37The Christie NHS Foundation Trust, Manchester Cancer Research Centre, and Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
38University Hospital of Wales, Cardiff, United Kingdom
39Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
40The Royal Wolverhampton NHS Trust, Wolverhampton, GBR
41Mayo Clinic Arizona, Phoenix
42The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore
43Levine Cancer Institute, Atrium Health, Charlotte, NC
44Moffitt Malignant Hematology at Memorial Healthcare System, Pembroke Pines
45Memorial Sloan Kettering Cancer Center, New York City
46James Comprehensive Cancer Center, The Ohio State University, Columbus, OH
47University of Colorado School of Medicine, Denver, CO
48City of Hope National Medical Center, Duarte, CA
49The Christie NHS Foundation Trust, Manchester, United Kingdom
50Division of Hematology-Oncology, Mayo Clinic-Florida, Jacksonville, FL
51Princess Margaret Cancer Centre, Toronto, Canada
52Barts Cancer Institute, London, United Kingdom
53Oxford University Hospital, Oxford, ENG, GBR
54Washington University Medical School, St Louis, MO
55Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
56University College London, London, United Kingdom

Introduction: Scant data exist on prognostic factors, survival and treatment (Tx)-related outcomes in SCNSL. We conducted a multicenter international analysis to identify prognostic factors and outcomes in SCNSL at diagnosis (de novo), or after frontline Tx (1L) either with (concomitant) or without (isolated) systemic (syst) relapse.

Methods: This study collected data from patients (pts) treated between 2001-2023 at 35 centers. Overall (OS) and progression-free survival (PFS) were calculated from SCNSL diagnosis to first event (death for OS, relapse/death for PFS) or last follow-up. Uni- (UVA) and multivariable (MVA) Cox analyses were performed to assess prognostic factors; Kaplan-Meier method was used to estimate survival.

Results: 1173 (US: 863, UK: 273, Canada: 37) pts with SCNSL were included. Baseline characteristics were median age: 62 years (interquartile range 52.5-69), male sex: 58.7%, elevated LDH: 71.1%, stage III/IV: 88.6%, HIV: 3%, transformed LBCL (tLBCL): 13.8%, non-germinal center B-cell like (non-GCB) subtype: 52.3%, double expressor (DE): 40%, MYC rearrangement (MYC-R): 28.3%, MYC/BCL2 double hit: 16.6%, MYC/BCL2/BCL6 triple hit (TH): 6.1%.

Among 522 pts with de novo SCNSL, 84.2% had involvement of a single CNS compartment (44.7% brain parenchyma; 40.4% leptomeningeal [lepto]). 1L regimens included 36.2% R-CHOP with high-dose methotrexate (HD-MTX), 12.5% MARIETTA-type, and 9.8% R-CODOX-M/IVAC; 54.6% received intrathecal chemotherapy. Consolidation Thiotepa-based autologous stem cell transplant (TT-ASCT) occurred in 15.3%. The majority of pts who underwent TT-ASCT had previously achieved CR or PR in syst (92.5%) and CNS (72.5%) compartments. At median follow-up 25.7 months (mos), subsequent relapse was observed in 27.5% TT-ASCT recipients: 36.3% had isolated CNS, 27.4% syst, and 36.3% concomitant.

588 pts presented with SCNS after 1L (66.2% isolated, 33.8% concomitant). Brain parenchyma involvement was observed in 56.8%, lepto in 22.6%. Tx included 31.6% HD-MTX combination (eg, R-MPV, MTR); 18.4% HD-MTX +/- rituximab; 16.2% MARIETTA-type; and 9.4% platinum-based regimen. Consolidation TT-ASCT occurred in 22.4% (n=132), and 13.8% (n=81) received CAR-T cell therapy (excluding subsequent relapses in de novo group). Syst (65.1%) & CNS (69.1%) responses (CR/PR) were higher before TT-ASCT compared to CAR-T cell (49.5% & 54.5%, respectively). After TT-ASCT, 52 pts (39.3%) relapsed, mainly in the CNS (n=30, 57.7%), with only 4 (7.7%) concomitant. After CAR-T, 48 pts (59.3%) relapsed: 15 (31.2%) isolated in CNS and 15 (31.2%) concomitant. 12-month cumulative incidence of relapse (with death as competing risk) was 21.1% after TT-ASCT and 55.8% after CAR-T. In 63 pts (5.4%), the first CNS event occurred >2 lines of Tx.

With median follow-up of the entire cohort of 24.6 mos, median PFS and OS were 11 and 21 mos, respectively. mPFS and mOS were significantly better in pts with de novo SCNSL (13.4 & 47.4 mos) compared to SCNSL after 1L (10.4 & 14.2 mos) and >2 lines of Tx (6.5 & 9.7 mos); P<0.0001. Factors associated with significantly shorter OS in UVA across all presentations were age >60, male sex, GCB subtype, MYC-R, tLBCL, DE, TH, elevated LDH, ECOG PS ≥2, SCNSL after 1L (vs. de novo), and failure to achieve syst/CNS response to 1L. Of these, age >60, male sex, MYC-R, ECOG PS ≥2, and failure to achieve response to 1L remained significant in MVA.

In de novo cases, age >60, DE, ECOG PS≥2, and failure to achieve syst/CNS response to 1L were associated with poorer OS; for pts with SCNSL after 1L, age >60, GCB subtype, and ECOG PS ≥2 were significant. Pts treated with HD-MTX-based regimens after 1L experienced longer OS than those treated with platinum regimens or high-dose cytarabine. In de novo cases, TT-ASCT was significantly associated with longer OS (HR=0.58; P=0.025) in MVA after adjusting for significant factors, 1L type, and response. For SCNSL at relapse, TT-ASCT (HR=0.34; P<.0001) and isolated SCNSL presentation (vs. concomitant HR=0.70, P=0.007) were associated with longer OS, adjusting for significant factors, type of second-line Tx, & site of CNS relapse.

Conclusions: This study represents the largest analysis of SCNSL inclusive of all modes of presentation. Concomitant SCNSL at relapse was associated with poor outcomes, while TT-ASCT consolidation was associated with improved OS in de novo & relapsed disease. Despite advances in LBCL SCNSL remains an unmet therapeutic need.

Disclosures: Alderuccio: BeiGene: Research Funding; Genmab: Research Funding; AbbVie: Consultancy; Regeneron: Consultancy; ADC Therapeutics: Consultancy, Research Funding; Genentech: Consultancy. Wang: Kite: Honoraria; InnoCare, AbbVie: Consultancy; Eli Lilly, LOXO Oncology, TG Therapeutics, Incyte, InnoCare, Kite, Jansen, BeiGene, AstraZeneca, Genmab, AbbVie: Other: Advisory Board; Incyte, InnoCare, LOXO Oncology, Eli Lilly, MorphoSys, Novartis, Genentech, Genmab, AbbVie, BeiGene, Merck: Research Funding. Wagner-Johnston: AstraZeneca: Research Funding; Genentech: Research Funding; Merck: Research Funding; Beigene: Consultancy. Olszewski: Genmab, Schrodinger, ADC Therapeutics, BeiGene, Bristol-Myers Squibb: Consultancy; Genmab, Schrodinger, Genentech, Inc., Precision Biosciences, Artiva, Pfizer, Kymera Therapeutics: Research Funding. Grover: Novartis: Honoraria; Regeneron: Honoraria, Research Funding; ADC Therapeutics: Honoraria; BMS: Honoraria, Research Funding; Caribou: Honoraria; Ono Pharma: Honoraria; Genentech: Honoraria; Cabaletta: Research Funding; Janssen: Honoraria; Kite: Honoraria; Sangamo: Current holder of stock options in a privately-held company; Seagen: Honoraria; Poseida: Research Funding. Koff: BeiGene: Consultancy; Viracta Therapeutics: Research Funding; AbbVie: Consultancy. Ramakrishnan Geethakumari: Ipsen Biopharma: Membership on an entity's Board of Directors or advisory committees; Ono Pharma: Membership on an entity's Board of Directors or advisory committees; Cellectar Biosciences: Membership on an entity's Board of Directors or advisory committees; ADC therapeutics: Membership on an entity's Board of Directors or advisory committees; Kite Pharma: Consultancy; Bristol Myers Squibb: Consultancy; Regeneron Pharma: Membership on an entity's Board of Directors or advisory committees. Moyo: Genmab: Research Funding; J&J: Research Funding; Century Therapeutics: Research Funding; Kite Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees. Epperla: Incyte Corporation: Research Funding; Lilly: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; BeiGene: Research Funding, Speakers Bureau; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Genentech: Speakers Bureau; ADC Therapeutics: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Merck: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Research Funding. Wallace: Integrity CME: Honoraria. Kamdar: Abbvie: Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Membership on an entity's Board of Directors or advisory committees; BMS: Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees; Genentech: Research Funding; Novartis: Research Funding; SeaGen: Speakers Bureau; TG Therapeutics: Research Funding. Danilov: Cyclacel: Research Funding; Bristol Meyers Squibb: Consultancy, Research Funding; ADCT: Consultancy; MEI Pharma: Research Funding; Takeda: Research Funding; Bayer: Consultancy, Research Funding; TG Therapeutics: Consultancy, Research Funding; Incyte: Consultancy; MorphoSys: Consultancy; Nurix: Consultancy, Research Funding; Genentech: Consultancy; BeiGene: Consultancy; AbbVie: Consultancy; AstraZeneca: Consultancy, Research Funding; GenMab: Consultancy, Research Funding; Janssen: Consultancy. Tun: Curis: Consultancy; Gossamerbio: Research Funding. Munoz: Pharmacyclics/Abbvie: Consultancy, Honoraria, Research Funding; Kyowa: Consultancy; Alexion: Consultancy; Fosunkite: Consultancy; Seattle Genetics: Consultancy, Research Funding; Karyopharm: Consultancy; Aurobindo: Consultancy; Genmab: Consultancy; Genzyme: Consultancy; Genentech/Roche: Consultancy, Research Funding; ADC Therapeutics: Consultancy; Epizyme: Consultancy; Bayer: Consultancy, Research Funding; Merck: Research Funding; Portola: Research Funding; Curio: Honoraria; OncView: Honoraria; Physicians' Education Resource: Honoraria; Eli Lilly: Consultancy; Pharmacyclics/Abbvie, Bayer, Gilead/Kite, Beigene, Pfizer, Janssen, Celgene/Bristol Myers Squibb, Kyowa, Alexion, Fosunkite, Seattle Genetics, Karyopharm, Aurobindo, Verastem, Genmab, Genzyme, Genentech/Roche, ADC Therapeutics, Epizyme, Beigene, Novartis,: Consultancy; Targeted Oncology: Honoraria; Alexion: Consultancy; BeiGene: Consultancy; Bayer: Consultancy, Research Funding; Gilead/Kite: Consultancy, Research Funding; Morphosys/Incyte: Consultancy, Research Funding; Novartis: Consultancy, Research Funding; MEI: Consultancy; TG Therapeutics: Consultancy; AstraZeneca: Consultancy; Celgene/Bristol Myers Squibb: Consultancy, Research Funding; Beigene: Consultancy, Research Funding; Pfizer: Consultancy; Janssen: Consultancy, Research Funding; Verastem: Consultancy, Research Funding; Targeted Oncology, OncView, Curio, Genzyme, and Physicians' Education Resource.: Honoraria; Bayer, Gilead/Kite, Celgene, Merck, Portola, Incyte, Genentech, Pharmacyclics, Seattle Genetics, Janssen, Millennium, Novartis, Beigene.: Research Funding. Narkhede: Lilly Oncology: Speakers Bureau; Natera: Research Funding; ADC Therapeutics: Consultancy, Honoraria, Research Funding; Cullinan Oncology: Research Funding; Adaptive Biotechnologies: Speakers Bureau; Genmab: Consultancy, Honoraria, Research Funding; Abbvie: Consultancy, Honoraria, Research Funding, Speakers Bureau; Beigene: Consultancy, Honoraria, Research Funding, Speakers Bureau; EUSA/Recordati Disease: Research Funding; Genentech-Roche: Speakers Bureau. Rhodes: AbbVie: Consultancy, Research Funding; Oncternal Therapeutics: Research Funding; Loxo Oncology: Research Funding; Janssen: Research Funding; TG Therapeutics: Consultancy; Seagen: Consultancy; Pharmacyclics: Consultancy, Research Funding; MorphoSys: Consultancy; Epizyme: Consultancy; Johnson and Johnson: Consultancy; Acerta: Research Funding; Verastem: Consultancy; ADC Therapeutics: Consultancy; Genentech: Consultancy; VelosBio: Research Funding; Beigene: Consultancy. Kuhnl: Astra Zeneca: Honoraria, Other: Travel grant; Abbvie: Consultancy; Roche: Consultancy; Kite Gilead: Consultancy, Honoraria; BMS: Consultancy. Okosun: BeiGene: Research Funding; AstraZeneca: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Genmab: Membership on an entity's Board of Directors or advisory committees, Research Funding; Incyte: Consultancy. Smith: MSD: Honoraria; Roche: Honoraria; Gilead: Honoraria; Beigene: Honoraria; AstraZeneca: Honoraria; AbbVie: Honoraria. Osborne: Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees; Pfizer: Honoraria; Kite Gilead: Honoraria, Membership on an entity's Board of Directors or advisory committees; Astra Zeneca: Honoraria; Novartis: Honoraria; Kyowa Kirin: Honoraria, Membership on an entity's Board of Directors or advisory committees; Incyte: Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; BMS: Honoraria, Membership on an entity's Board of Directors or advisory committees; Servier: Membership on an entity's Board of Directors or advisory committees; MSD: Membership on an entity's Board of Directors or advisory committees; Beigene: Membership on an entity's Board of Directors or advisory committees; Autolus: Membership on an entity's Board of Directors or advisory committees; Sobi: Membership on an entity's Board of Directors or advisory committees; Syneos: Membership on an entity's Board of Directors or advisory committees. el-Sharkawi: SOBI: Membership on an entity's Board of Directors or advisory committees; Novartis: Other: Conference/travel support; AstraZeneca: Honoraria, Membership on an entity's Board of Directors or advisory committees; ASTEX: Membership on an entity's Board of Directors or advisory committees; Nurix: Honoraria; Takeda: Honoraria; Roche: Honoraria, Other: Conference/travel support; AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Conference/travel support; Adaptive: Honoraria; Kyowa Kirin: Membership on an entity's Board of Directors or advisory committees; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Beigene: Membership on an entity's Board of Directors or advisory committees. Collins: Sobi: Consultancy, Honoraria; Beigene: Consultancy, Honoraria, Research Funding, Speakers Bureau; Kite: Honoraria, Speakers Bureau; Pfizer: Research Funding; Amgen: Research Funding; BMS: Research Funding; Astra Zeneca: Consultancy, Honoraria; Takeda: Consultancy, Honoraria, Speakers Bureau; Abbvie: Consultancy, Honoraria, Speakers Bureau; Roche: Consultancy, Honoraria, Speakers Bureau. Linton: Viracta: Research Funding; Regeneron: Research Funding; AbbVie: Consultancy, Research Funding, Speakers Bureau; BeiGene: Consultancy, Research Funding; BMS: Consultancy, Other: Travel Expenses, Research Funding, Speakers Bureau; Nurix: Research Funding; Celgene: Consultancy, Other: Travel Expenses, Research Funding, Speakers Bureau; Step Pharma: Research Funding; Kite/Gilead: Consultancy, Research Funding; Genmab: Consultancy, Other: Member of the Epcoritamab Global Council, Research Funding; MSD: Research Funding; Janssen: Research Funding; MorphoSys: Research Funding; CellCentric: Research Funding; AstraZeneca: Research Funding; ADC Therapeutics: Research Funding; Roche: Consultancy, Research Funding. Ollila: ADC Therapeutics: Membership on an entity's Board of Directors or advisory committees; Lilly: Research Funding; Ono Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees, Research Funding. Ghosh: Seagen, TG Therapeutics, AstraZeneca, Pharmacyclics, Janssen, Bristol Myers Squibb, Gilead Sciences, Beigene, Incyte, Karyopharm, Roche/Genentech, Novartis, Loxo Oncology, Genmab, Adaptive Biotech, ADC Therapeutics and Syncopation: Consultancy; TG Therapeutics, Genentech/Roche, Bristol Myers Squibb, Gilead, Morphosys, AbbVie: Research Funding; Roche/Genentech, AbbVie, BMS: Research Funding; AstraZeneca, Pharmacyclics, Janssen, BMS, Kite Pharma, BeiGene, Incyte, Lava Therapeutics, Roche/Genentech, Novartis, Loxo Oncology, AbbVie, Genmab, Prepromene, and ADC Therapeutics, Ascentage and Ipsen.: Honoraria; AstraZeneca, Pharmacyclics, Janssen, BMS, Gilead Sciences, Kite Pharma, BeiGene, Incyte, Lava Therapeutics, Roche/Genentech, Novartis, Loxo Oncology, AbbVie, Genmab, Adaptive Biotech, Prepromene, Ascentage and Ipsen: Consultancy. Kahl: AstraZeneca, BeiGene, Roche: Research Funding; BMS, BeiGene, Lilly, Kite, AZ, AbbVie, Merck, Novartis, Genentech, Roche, ADCT: Consultancy. Chavez: Cellectis: Consultancy; Allogene: Consultancy; Lilly: Honoraria, Speakers Bureau; Janssen: Honoraria; Merck: Research Funding; ADC Therapeutics: Consultancy; Abbvie: Consultancy; GenMab: Consultancy, Research Funding; BeiGene: Consultancy, Honoraria, Speakers Bureau; AstraZeneca: Consultancy; Novartis: Consultancy; Kite, a Gilead Company: Consultancy. Cwynarski: BMS: Consultancy; Incyte: Consultancy, Speakers Bureau; Kite: Consultancy, Speakers Bureau; Gilead: Consultancy, Speakers Bureau; AbbVie, Celgene, Atara, Janssen,: Consultancy; Roche, Takeda: Consultancy, Speakers Bureau.

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*signifies non-member of ASH