%0 Journal Article
%T Hematopoietic stem cell transplantation for DLBCL: a report from the European Society for Blood and Marrow Transplantation on more than 40,000 patients over 32 years.
%A Berning P
%A Fekom M
%A Ngoya M
%A Goldstone AH
%A Dreger P
%A Montoto S
%A Finel H
%A Shumilov E
%A Chevallier P
%A Blaise D
%A Strüssmann T
%A Carpenter B
%A Forcade E
%A Castilla-Llorente C
%A Trneny M
%A Ghesquieres H
%A Capria S
%A Thieblemont C
%A Blau IW
%A Meijer E
%A Broers AEC
%A Huynh A
%A Caillot D
%A Rösler W
%A Nguyen Quoc S
%A Bittenbring J
%A Nagler A
%A Galimard JE
%A Glass B
%A Sureda A
%A Schmitz N
%J Blood Cancer J
%V 14
%N 1
%D 2024 Jul 5
%M 38969655
%F 9.812
%R 10.1038/s41408-024-01085-9
%X Autologous(auto-) and allogeneic(allo-) hematopoietic stem cell transplantation (HSCT) are key treatments for relapsed/refractory diffuse large B-cell lymphoma (DLBCL), although their roles are challenged by CAR-T-cells and other immunotherapies. We examined the transplantation trends and outcomes for DLBCL patients undergoing auto-/allo-HSCT between 1990 and 2021 reported to EBMT. Over this period, 41,148 patients underwent auto-HSCT, peaking at 1911 cases in 2016, while allo-HSCT saw a maximum of 294 cases in 2018. The recent decline in transplants corresponds to increased CAR-T treatments (1117 cases in 2021). Median age for auto-HSCT rose from 42 (1990-1994) to 58 years (2015-2021), with peripheral blood becoming the primary stem cell source post-1994. Allo-HSCT median age increased from 36 (1990-1994) to 54 (2015-2021) years, with mobilized blood as the primary source post-1998 and reduced intensity conditioning post-2000. Unrelated and mismatched allo-HSCT accounted for 50% and 19% of allo-HSCT in 2015-2021. Three-year overall survival (OS) after auto-HSCT improved from 56% (1990-1994) to 70% (2015-2021), p < 0.001, with a decrease in relapse incidence (RI) from 49% to 38%, while non-relapse mortality (NRM) remained unchanged (4%). After allo-HSCT, 3-year-OS increased from 33% (1990-1999) to 46% (2015-2021) (p < 0.001); 3-year RI remained at 39% and 1-year-NRM decreased to 19% (p < 0.001). Our data reflect advancements over 32 years and >40,000 transplants, providing insights for evaluating emerging DLBCL therapies.