Impact of Cell of Origin on Outcomes After Autologous Hematopoietic Cell Transplant in Diffuse Large B-Cell Lymphoma

Madiha Iqbal, Yennifer Gil Castano, Jonas Paludo, Allison Rosenthal, Zhuo Li, Manuel Beltran, Muhamad Alhaj Moustafa, David Inwards, Luis Porrata, Ivana Micallef, Jose C.Villasboas Bisneto, Patrick Bruce Johnston, Stephen M. Ansell, Craig B Reeder, Hemant Murthy, Vivek Roy, James Foran, Han W. Tun, Mohamed A. Kharfan-Dabaja, Ernesto Ayala

Research output: Contribution to journalArticlepeer-review

Abstract

Germinal center B-cell-like diffuse large B cell lymphoma (GCB-DLBCL) at diagnosis is associated with superior long-term outcomes compared to non-GCB-DLBCL in patients treated with conventional chemo-immunotherapy. Whether cell of origin (COO) by Hans algorithm retains its prognostic significance in patients with (R/R) relapsed/refractory DLBCL undergoing autologous hematopoietic cell transplant (auto-HCT) is not well established. Three hundred and fifty-seven patients underwent auto-HCT between 2005 and 2018. The COO status was determined in 284 patients and these were included in the analysis. One hundred ninety-four patients had GCB-DLBCL while 90 had non-GCB-DLBCL. Median follow up was 1.7 (0-13) years. The GCB-DLBCL was associated with inferior 5-year overall survival at 44% (95%CI, 36-52) versus 64% (95%CI, 54-77) (P =.004) and a higher relapse incidence at 67% (95%CI, 58-74) versus 49% (95%CI, 35-60) (P =.01) in the non-GCB-DLBCL. The difference between GCB and non-GCB-DLBCL remained statistically significant in multivariate analysis. Additionally, response at the time of transplant was an independent prognostic factor. GCB-DLBCL was enriched in double-hit and triple hit phenotype based on available fluorescence in situ hybridization data. These results suggest an enrichment of high-risk genetic rearrangements in R/R GCB-DLBCL resulting in limited efficacy of auto-HCT.

Original languageEnglish (US)
JournalClinical Lymphoma, Myeloma and Leukemia
DOIs
StateAccepted/In press - 2021

Keywords

  • Autologous hematopoeitic cell transplant
  • Autologous hematopoeitic cell transplany
  • Cell of origin
  • Chemo-immunotherapy
  • Germinal center diffuse large B-cell lymphoma

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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