% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @ARTICLE{Derigs:282877, author = {P. Derigs and W. A. Bethge and I. Krämer and U. Holtick and B. von Tresckow$^*$ and F. Ayuk and O. Penack and V. Vucinic and M. von Bonin and C. Baldus and D. Mougiakakos and G. Wulf and U. Schnetzke and M. Stelljes and M. Fante and R. Schroers and N. Kroeger and P. Dreger}, title = {{L}ong-{T}erm {S}urvivors {A}fter {F}ailure of {CAR}-{T} {C}ell {T}herapy for {L}arge {B}-{C}ell {L}ymphoma: {A} {R}ole for {A}llogeneic {H}ematopoietic {C}ell {T}ransplantation? {A} {GLA}/{DRST} {A}nalysis.}, journal = {Transplantation and cellular therapy}, volume = {29}, number = {12}, issn = {2666-6375}, address = {[Amsterdam]}, publisher = {Elsevier B. V.}, reportid = {DKFZ-2023-01879}, pages = {750-756}, year = {2023}, note = {2023 Dec;29(12):750-756}, abstract = {The outcome of patients with large B-cell lymphoma (LBCL) who relapse or progress after CD19-directed CAR-T cell therapy administered as salvage therapy beyond the second treatment line is poor. However, a minority of patients become long-term survivors despite CAR-T failure. The German Lymphoma Alliance (GLA) has proposed a hierarchical management algorithm for CAR-T failure in LBCL, aiming at allogeneic hematopoietic cell transplantation (alloHCT) as definite therapy in eligible patients.The purpose of this study was to investigate characteristics, relapse patterns and management strategies in long-term survivors after CAR-T failure with particular focus on feasibility and outcome of alloHCT.Retrospective analysis of all evaluable patients with relapse/progression event (REL) observed in a previous reported GLA sample (Bethge et al, Blood 2022) between November 2018 and May 2021.REL occurred in 214 of 356 patients $(60\%)$ having undergone CAR-T for LBCL in the previous GLA study. For 143 of these 214 patients $(67\%)$ an evaluable dataset was available. 26 of 143 patients $(18\%)$ survived 12 months or longer from REL, 109 $(76\%)$ died within the first year after REL, and 8 patients $(6\%)$ were alive but had not reached the 12-months landmark. Long-term survivors had more favorable pre-CAR-T features, had a longer interval between CAR-T and REL, and had more often received a tumor biopsy post CAR-T failure, whereas the choice of the first salvage regimen had no impact. AlloHCT was feasible in 40 of 53 patients $(75\%)$ intended and resulted in a 12-month post-transplant overall survival of $36\%$ in those patients who underwent transplant with sensitive or untreated REL.AlloHCT after CAR-T failure in LBCL is feasible and may be an important contributor to long-term survival although selection bias has to be taken into account. Thus, alloHCT should be considered as a reasonable treatment option in eligible patients in this setting. Since the overall outlook after CAR-T failure nevertheless remains poor, novel effective therapeutic approaches are needed, either for allowing long-term disease control per se, or for improving the preconditions for successful alloHCT.}, keywords = {Allogeneic Hematopoietic Cell Transplantation (Other) / CAR-T (Other) / Lymphoma (Other) / Relapse (Other)}, cin = {ED01}, ddc = {610}, cid = {I:(DE-He78)ED01-20160331}, pnm = {899 - ohne Topic (POF4-899)}, pid = {G:(DE-HGF)POF4-899}, typ = {PUB:(DE-HGF)16}, pubmed = {pmid:37709204}, doi = {10.1016/j.jtct.2023.09.008}, url = {https://inrepo02.dkfz.de/record/282877}, }