Preliminary results of CAR-T–based consolidation with or without ASCT for patients with relapsed/refractory large B-cell lymphoma in complete remission after salvage therapy

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CAR-T therapy, alone or combined with autologous stem cell transplantation (ASCT), is used as consolidation in relapsed/refractory large B-cell lymphoma (r/r LBCL) patients achieving complete remission (CR) after salvage therapy. However, the relative contributions of these approaches to long-term disease control in this remission setting remain unclear. We retrospectively analyzed 30 patients with r/r LBCL who achieved CR after salvage therapy and subsequently received CAR-T–based consolidation, either alone (n = 15) or combined with ASCT (n = 15). With a median follow-up of 39.4 months, median progression-free survival (PFS) and overall survival (OS) were not reached. The 3-year PFS and OS rates were 73.0% and 82.8%, respectively. Among patients receiving CAR-T alone, the 3-year PFS and OS rates were 65.5% and 77.8%, respectively, while those receiving CAR-T plus ASCT achieved corresponding rates of 80.0% and 86.7%. Among patients with central nervous system involvement, early treatment failure, or MYC rearrangement, favorable trends in PFS and OS were observed in patients who received CAR-T plus ASCT. CAR-T–based consolidation may be associated with durable disease control, and exploratory analyses suggested favorable trends with CAR-T plus ASCT consolidation in selected high-risk subgroups. The findings are preliminary and warrant further investigation in larger, prospective studies to establish their clinical relevance.

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