%0 Journal Article
%T Early failure is still a poor prognostic factor in patients with relapsed or refractory large B-cell lymphoma in the era of CAR T-cell therapy.
%A Yagi Y
%A Kanemasa Y
%A Sasaki Y
%A Goto S
%A Yamamura Y
%A Masuda Y
%A Fujita K
%A Ishimine K
%A Hayashi Y
%A Mino M
%A Ohigashi A
%A Morita Y
%A Tamura T
%A Nakamura S
%A Okuya T
%A Matsuda S
%A Shimizuguchi T
%A Shingai N
%A Toya T
%A Shimizu H
%A Najima Y
%A Kobayashi T
%A Haraguchi K
%A Doki N
%A Okuyama Y
%A Shimoyama T
%J J Clin Exp Hematop
%V 64
%N 2
%D 2024
%M 38925972
暂无%R 10.3960/jslrt.24009
%X Patients with refractory or relapsed (R/R) large B-cell lymphoma (LBCL) refractory to first-line chemotherapy or with early relapse have poor outcomes. While chimeric antigen receptor (CAR) T-cell therapy has impressive efficacy after two or more lines of chemotherapy, it's still uncertain if these outcomes remain consistent in the context of third-line CAR T-cell therapy. We conducted a retrospective study of 107 R/R LBCL patients. Patients with relapse 12 months or more after their first-line chemoimmunotherapy (late failure: n = 25) had significantly longer overall survival (OS) than patients with refractory disease or relapse within 12 months (early failure: n = 82) (median OS: not achieved vs. 18.4 months; P < 0.001). Among patients who proceeded to autologous hematopoietic stem-cell transplantation (auto-HSCT), those with late failure had significantly longer event-free survival (EFS) than those with early failure (median EFS: 26.9 vs. 3.1 months; P = 0.012). However, no significant difference in EFS was detected among patients who underwent CAR T-cell therapy (median EFS: not reached vs. 11.8; P = 0.091). Cox regression with restricted cubic spline demonstrated that timing of relapse had significant impact on EFS in patients with auto-HSCT but not in patients with CAR T-cell therapy. Of patients who were scheduled for CAR T-cell therapy, those with late failure were significantly more likely to receive CAR T-cell therapy than those with early failure (90% vs. 57%; P = 0.008). In conclusion, patients with early failure still experienced poor outcomes after the approval of third-line CAR T-cell therapy.