Clinical Lymphoma, Myeloma & Leukemia最新文献

{"title":"Real World Evidence From 2 Decades of First-Line TKI Therapy in Chronic Myeloid Leukemia (CML): Insights From ACHO's RENEHOC Registry.","authors":"Virginia Abello Polo, Claudia Sossa, Carla Boquimpani, Luis Antonio Salazar, Isabel Munevar, Rigoberto Gómez, Diana Marcela Cuervo, Carlos Varón Jaimes, Jheremy Reyes, Henry Idrobo, Paola Omaña, Jorge Daza, Julian Eduardo Pedraza Morales, Claudia Agudelo López, Guillermo E Quintero-Vega, Mario Correa Correa, Juan Manuel Herrera, William Armando Mantilla, Juan Carlos Serrano, Carmen Rosales, Kenny Mauricio Gálvez Cárdenas, Carlos Bermúdez, Domingo Saavedra Ramírez, Mauricio Alzate, José Fernando Lobatón Ramírez","doi":"10.1016/j.clml.2024.12.015","DOIUrl":"https://doi.org/10.1016/j.clml.2024.12.015","url":null,"abstract":"<p><strong>Background: </strong>Chronic myeloid leukemia (CML) treatment has significantly evolved with the introduction of tyrosine kinase inhibitors. However, access to these treatments and outcomes vary globally. This study examines 2 decades of CML management in Colombia using the RENEHOC registry, focusing on TKI efficacy, safety, and healthcare system challenges.</p><p><strong>Methods: </strong>We performed a descriptive analysis of the sociodemographic and clinical characteristics of 994 CML patients from the RENEHOC cohort in Colombia, who were treated over the past 20 years. Trends in first-line TKI use were assessed, and Kaplan-Meier survival curves were used to estimate EFS and OS. The log-rank test was used to compare survival curves between different first-line TKIs.</p><p><strong>Results: </strong>The analysis shows trends in the use of first-line TKIs over a 20-year period in Colombia, where, as in other countries, the use of second-generation TKIs in the first-line setting is gradually increasing. Despite the difficulties of the Colombian healthcare system, the results in terms of OS are excellent regardless of the first-line TKI; however, patients treated with imatinib switched lines significantly more often than those treated with second-generation TKIs (imatinib 58.7%, nilotinib 19.5%, dasatinib 29.3%). The median duration of treatment was significantly shorter with imatinib compared to dasatinib and nilotinib (4.08, 12.75 and not reached, respectively). Intolerance was the most common reason for switching in this cohort of patients. The median observation time for OS was 64.89 months (SD 60.15), with survival rates of 99.4% at 1 year, 97.7% at 3 years and 96.6% at 5 years.</p><p><strong>Conclusions: </strong>The results of this analysis show excellent results in terms of OS for patients with CML treated in Colombia over the last 20 years, despite the difficulties inherent in the health system. Patients treated with first-line imatinib had more frequent line changes. In general, intolerance was the most common reason for switching lines. Despite its retrospective nature, this study allows us to outline how treatment patterns in the country have changed over time. Continued efforts to include more centers and patients in prospective studies are essential to better understand the long-term effects of treatment and to improve adherence to guideline recommendations in clinical practice.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of Real-World Experience With Ruxolitinib for Myelofibrosis.","authors":"Haifa Kathrin Al-Ali, Aaron T Gerds, Michael R Grunwald, Jingbo Yu","doi":"10.1016/j.clml.2024.12.013","DOIUrl":"https://doi.org/10.1016/j.clml.2024.12.013","url":null,"abstract":"<p><p>Myelofibrosis (MF) is a rare myeloproliferative neoplasm characterized by progressive bone marrow fibrosis and splenomegaly. Ruxolitinib is the standard-of-care first-line treatment option for MF. This review summarizes real-world effectiveness and safety of ruxolitinib in more than 4500 patients with MF from real-world settings, including expanded-access and phase 4 trials, as well as registry, postmarketing, and retrospective studies in the 10 years since regulatory approval. Consistent with results from the phase 3 COMFORT trials, real-world evidence supports the effectiveness of ruxolitinib in improving splenomegaly and MF symptoms while significantly increasing overall survival. Real-world safety data have also been aligned with results from the COMFORT trials. Transient anemia, thrombocytopenia, and infections are the most frequently observed adverse events (AEs) but rarely required ruxolitinib discontinuation. Other nonhematologic AEs are generally mild, and grade ≥ 3 events rarely occur. Importantly, real-world evidence also supports the effectiveness of ruxolitinib in patient groups that were poorly represented in clinical trials, including those with lower-risk MF, those presenting with thrombocytopenia or anemia, and those who have previously discontinued ruxolitinib treatment. Finally, cost-effectiveness analyses show ruxolitinib to be cost-effective in Europe and North America. Taken together, real-world studies reinforce the efficacy, safety, and cost-effectiveness of ruxolitinib for the treatment of patients with MF, supporting results from prospective clinical trials. Furthermore, they demonstrate the clinical benefit of ruxolitinib in patient subgroups poorly represented in clinical trials and the value of dose modifications or re-treatment after interruptions to optimize outcomes.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consolidation With Second High Dose Therapy and Autologous Stem Cell Transplantation Is Associated With Improved Overall Survival in Patients With Multiple Myeloma in First Relapse.","authors":"Koen M Klomberg, Miriam Gelderloos, Hilde A M Kooistra, Marcel Nijland, Gerwin A Huls, Wilfried W H Roeloffzen, Wouter J Plattel","doi":"10.1016/j.clml.2024.12.010","DOIUrl":"https://doi.org/10.1016/j.clml.2024.12.010","url":null,"abstract":"<p><strong>Background: </strong>High dose chemotherapy and autologous stem cell transplantation (HDT/ASCT) remains the preferred first line consolidation strategy for newly diagnosed multiple myeloma (MM). However, The role of HDT/ASCT in first relapse is uncertain in the context of novel therapies. This study evaluates real-world outcomes of MM patients in first relapse, focusing on the role of consolidative HDT/ASCT.</p><p><strong>Patients and methods: </strong>This retrospective cohort study was conducted at a large tertiary referral center in Northern Netherlands. MM patients who received first-line HDT/ASCT and obtained a good response were included. The time to next treatment or death (TTNT-D 2) and overall survival (OS) were evaluated, while identifying prognostic factors. A landmark analysis was performed at 6 months, including only patients with a partial response (PR) or better after re-induction.</p><p><strong>Results: </strong>This study identified 237 patients potentially eligible for repeated HDT/ASCT of whom 111 (47%) underwent a second consolidative HDT/ASCT. The median follow-up is 40 months. Baseline characteristics were largely similar, though second HDT/ASCT was applied only after achieving PR or better. In the landmark analysis, absence of high-risk cytogenetics and good performance status were associated with longer TTNT-D 2. Consolidative second HDT/ASCT, absence of high-risk cytogenetics and longer first response duration were associated with longer OS. Transplantation-related mortality rate was < 1%.</p><p><strong>Conclusion: </strong>This study highlights the viability of second HDT/ASCT as treatment option for relapsed MM, particularly for patients with good responses to first-line HDT/ASCT. In the era of novel agents, second HDT/ASCT should be considered a feasible and effective consolidative strategy.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Myeloma in Italy: An Epidemiological Model by Treatment Line and Refractoriness Status.","authors":"Roberto Mina, Silvia Mangiacavalli, Bernardo Rossini, Gianni Ghetti, Simona Pellizzaro, Fabrizio Iannello, Stefania Bellucci","doi":"10.1016/j.clml.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.clml.2024.12.012","url":null,"abstract":"<p><strong>Background: </strong>Multiple myeloma (MM) clinical management is challenging owing to its relapse and refractoriness to treatment. Understanding the treatment patterns and refractory dynamics is crucial for optimizing patient care. This study aimed to estimate the evolution of MM according to the treatment line and refractoriness status in Italy.</p><p><strong>Materials and methods: </strong>A new epidemiological model was developed using epidemiological and clinical data from literature. Prevalent MM patients were characterized by calibrating the model inputs. Incident patients were included starting in 2021, when antiCD38-containing regimens were reimbursed as first-line treatments in Italy. The model employed a 1-year cycle Markov structure to simulate patient flow through the treatment lines, accounting for the development of lenalidomide and anti-CD38 monoclonal antibody (mAb) refractoriness.</p><p><strong>Results: </strong>In 2020, Italy had an estimated 33,734 prevalent MM patients. By 2027, treated patients were projected to increase from 28,499 to 35,074. The introduction of lenalidomide and mAb therapies in earlier lines has resulted in a higher accumulation of patients in the early lines, with a corresponding decrease in the proportion of patients requiring subsequent lines of therapy. Furthermore, the proportion of patients refractory to both lenalidomide and mAbs in the second to fourth lines of treatment is estimated to increase from 1.6% in 2021 to 29.7% by 2027.</p><p><strong>Conclusion: </strong>Our model revealed a rising prevalence of patients receiving first-line treatment owing to more effective treatments. The marked increase in the number of refractory patients in subsequent lines underscores the urgent need for innovative therapies to address treatment resistance.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tyrosine Kinase Inhibitor Treatment Patterns in Patients With Chronic-Phase Chronic Myeloid Leukemia: A Single Center Data From China","authors":"Meng-yao Yuan ,&nbsp;Xiao-shuai Zhang ,&nbsp;Qian Jiang","doi":"10.1016/j.clml.2024.12.008","DOIUrl":"10.1016/j.clml.2024.12.008","url":null,"abstract":"<div><h3>Aim</h3><div>To describe tyrosine kinase inhibitor (TKI) treatment patterns and analyze co-variates of TKI switch for chronic myeloid leukemia (CML) patients in a center from China.</div></div><div><h3>Methods</h3><div>A retrospectively study was designed to analyze TKI switching patterns, reasons and associated covariates in patients with CP-CML.</div></div><div><h3>Results</h3><div>1766 patients receiving initial imatinib (n = 1374), nilotinib (n = 254), dasatinib (n = 63) and flumatinib (n = 75) therapy were retrospectively interrogated. Median follow-up was 48 (IQR, 24-77) months. TKI switch proportions were 32% (570/1766) for first-line, 36% (208/570) for second-line and 34% (71/208) for third-line. Common therapy sequences included imatinib-dasatinib (37%) or nilotinib (35%) in those with 1 switch, imatinib-nilotinib-dasatinib (25%) with 2 switches and imatinib-nilotinib-dasatinib-olverembatinib (18%) with 3 switches. TKI switches were mainly due to resistance (64%, 76%, 88% across lines) and intolerance (19%, 14%, 7%). Multivariable analyses revealed ELTS intermediate/high-risk group (vs. low-risk), male, and lower hemoglobin were significantly associated with a higher probability of TKI switch. Compared to imatinib, initial nilotinib or dasatinib had lower switch rates. Male and ELTS high-risk (vs. low/intermediate) were associated with resistance-related switches, while lower hemoglobin, older age and initial dasatinib or flumatinib (vs. imatinib) were associated with intolerance-related switches to second-line therapy. Second-line imatinib/flumatinib (vs. nilotinib/dasatinib) and no/nonspecific <em>ABL</em> mutation were associated with resistance-related switches to third-line therapy.</div></div><div><h3>Conclusion</h3><div>These findings emphasized the complexities involved in the management of patients with CP-CML and highlighted the importance of personalized treatment strategies.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 4","pages":"Pages e243-e252"},"PeriodicalIF":2.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Neurocognitive Testing Tool for Early Neurotoxicity Detection Following Anti-CD19 and Anti-BCMA Chimeric Antigen Receptor (CAR) T-cell Therapy: A Pilot Study.","authors":"Arvind Suresh, Heather A Wishart, Maeen N Arslan, Raphael A Lizcano, Parth S Shah, Swaroopa PonnamReddy, Christi Ann Hayes, Bryce S Jacobson, Grant Moncrief, Pablo Martinez-Camblor, Amy M Chan, Kenneth R Meehan, John M Hill","doi":"10.1016/j.clml.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.clml.2024.12.011","url":null,"abstract":"<p><strong>Background: </strong>Immune effector cell-associated neurotoxicity syndrome (ICANS) can be a severe, life-threatening toxicity following CAR T-cell therapy. While currently evaluated by the immune effector cell-associated encephalopathy (ICE) score, not all patients have changes in their ICE score and not all signs and symptoms of neurotoxicity are captured.</p><p><strong>Methods: </strong>We conducted a prospective, single center cohort pilot study to evaluate a novel, rapid neurocognitive assessment tool (CART-NS) in detecting early, subtle neurotoxicity prior to the onset of ICANS and any deterioration in the ICE score. CART-NS includes 8 abbreviated forms of neurocognitive tests and 2 symptom questionnaires. Following baseline measurements, CART-NS was administered at 8-hour intervals during the first 30 days after CAR T-cell infusion.</p><p><strong>Results: </strong>Performance on all measures was significantly lower when patients developed Grade 1 or 2 ICANS (P < .05). Performance on Oral Symbol Digit, Stroop, and the Paced Visual Serial Addition Test was lower between Day 0 and +3 in patients who developed ICANS and persisted even after clinical resolution. Early changes in the Stroop test (AUC = 0.857, 95% CI 0.628-1.000) were most predictive of ICANS onset when measured during the first 36 hour following CAR T-cell infusion. Significant elevations in CRP, G-CSF, GM-CSF, IFNγ, IL-10, IL-15, IL-27, and MIG/CXCL-9 were associated with ICANS development.</p><p><strong>Conclusion: </strong>Brief neurocognitive testing can be feasibly applied for the early detection of ICANS after CAR T-cell therapy, predict which patients may go on to develop ICANS in the first 30 days, and overcome limitations of the ICE assessment tool.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Total Body Irradiation Versus Chemotherapy Conditioning for Hematopoietic Stem Cell Transplant in Adult Acute Lymphoblastic Leukemia: A Systematic Review and Meta-Analysis","authors":"Hasaan Ans ,&nbsp;Haiqah Amjad ,&nbsp;Sara Nazir ,&nbsp;Sara Sajjad Cheema ,&nbsp;Dhruv Mistry ,&nbsp;Tazeen Fatima ,&nbsp;Ahmed Yar Khan ,&nbsp;Muhammad Usama Imtiaz ,&nbsp;Fasih Mand Khan ,&nbsp;Saif Khalid ,&nbsp;Mohammad Ebad Ur Rehman ,&nbsp;Muhammad Salman Faisal","doi":"10.1016/j.clml.2024.12.007","DOIUrl":"10.1016/j.clml.2024.12.007","url":null,"abstract":"<div><div>Hematopoietic stem cell transplantation (HSCT) is a potentially curative option for adults with acute lymphoblastic leukemia (ALL) who have achieved remission. This systematic review and meta-analysis compare the efficacy of total body irradiation (TBI) versus chemotherapy (CHT) based regimens for conditioning in adult ALL patients being prepared for HSCT. A comprehensive literature search was conducted in MEDLINE, Embase, the Cochrane Library, and relevant trial registries from their inception to August 2024. The inclusion criteria encompassed all randomized controlled trials (RCTs) and cohort studies that compared TBI with CHT as conditioning regimens prior to HSCT in adult patients with ALL. The primary outcomes assessed were overall survival (OS) and event-free survival (EFS). All statistical analyses were carried out using RevMan version 5.4, using a random-effects model. This meta-analysis includes 20 cohort studies and one RCT. The relative risk (RR) for OS was 1.37 (95% CI: 1.20-1.57), while the RR for EFS was 1.28 (95% CI: 1.15-1.43), highlighting the superior efficacy of TBI-based regimens in this patient population. TBI was also superior in terms of relapse rate (RR 0.71). The 2 regimens were comparable in terms of nonrelapse mortality, acute graft-versus-host disease (GVHD), and chronic GVHD. When used for conditioning prior to HSCT, TBI-based conditioning regimens demonstrate superior OS, EFS, and relapse outcomes compared to CHT-based regimens.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 4","pages":"Pages e232-e242"},"PeriodicalIF":2.7,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Patients With Newly Diagnosed Acute Myeloid Leukemia Receiving Treatment in a Safety-Net Hospital System.","authors":"Jason Lu, Preeya Bhakta, Hyunsoo Hwang, Curtis Lachowiez, Effrosyni Apostolidou","doi":"10.1016/j.clml.2024.12.009","DOIUrl":"https://doi.org/10.1016/j.clml.2024.12.009","url":null,"abstract":"<p><strong>Background: </strong>'Standard of care' therapies for adult acute myeloid leukemia (AML) have yielded 5-year overall survival (OS) rates of 30%-45 %. Risk stratification and novel targeted therapies have improved 5-year OS rates to >75 % for certain groups in specialized centers.</p><p><strong>Patients and methods: </strong>This is a retrospective cohort analysis of outcomes in patients ≥18 years with newly diagnosed AML treated between 2005 and 2019 in the Harris Health County, Safety-Net Hospital System in Houston, TX.</p><p><strong>Results: </strong>192 patients were identified. Median age was 52 years, 52 % were male and 57 % identified as Hispanic. Most patients were uninsured or indigent, receiving care under the county's financial assistance programs (62 %). Of the 184 response-assessable patients, 139 achieved composite complete remission (CRc) (76 %). 182 patients had indications for HCT and only 25 patients received HCT (14 %), with main reasons including noncitizenship status and financial/insurance constraints. The 5-year OS rate in the entire cohort was 30 % (35 % in patients <60 years and 16 % if ≥60 years), with 92 % of deaths attributed to AML-related complications. Early death (<4 weeks) rate was 2 %. Secondary, adverse-risk AML, and uninsured status all portended significantly worse OS rates, per multivariate analysis. Patients with indications for HCT who received this modality fared significantly better than those who did not receive it (5-year OS 54 % vs. 21 %).</p><p><strong>Conclusions: </strong>Optimizing AML remission induction regimens, reducing medication costs, ensuring timely administration of AML directed therapies, enhancing equity and diversity in clinical trials, and addressing socioeconomic factors may improve leukemia care for underserved patients.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Journey Through the Golden Era of Myeloma Treatment: From Bench to Bedside.","authors":"Sundar Jagannath","doi":"10.1016/j.clml.2024.12.003","DOIUrl":"https://doi.org/10.1016/j.clml.2024.12.003","url":null,"abstract":"","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness of Chemoimmunotherapy and Novel Therapies for Patients With Relapsed/Refractory Aggressive Large B-Cell Lymphoma","authors":"Loretta J. Nastoupil ,&nbsp;Clark R. Andersen ,&nbsp;Amy Ayers ,&nbsp;Yucai Wang ,&nbsp;Thomas M. Habermann ,&nbsp;Dai Chihara ,&nbsp;Brad S. Kahl ,&nbsp;Brian K. Link ,&nbsp;Jean L. Koff ,&nbsp;Jonathon B. Cohen ,&nbsp;Peter Martin ,&nbsp;Izidore S. Lossos ,&nbsp;Michele Stanchina ,&nbsp;Sara Haddadi ,&nbsp;Carla Casulo ,&nbsp;Sabarish Ayyappan ,&nbsp;Ruitao Lin ,&nbsp;Ziyi Li ,&nbsp;Melissa A. Larson ,&nbsp;Matthew J. Maurer ,&nbsp;Christopher R. Flowers","doi":"10.1016/j.clml.2024.11.014","DOIUrl":"10.1016/j.clml.2024.11.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Clinical trials provide meaningful data regarding the safety and efficacy of novel therapies but there is often a lag between the time of new drug approval and information on posttreatment clinical outcomes in real-world practice. This study evaluated clinical outcomes in a large real-world population of patients with relapsed and/or refractory large B-cell lymphoma (r/r LBCL) treated with chemoimmunotherapy or novel therapies in second or later lines of therapy (2L+).</div></div><div><h3>Materials and Methods</h3><div>Data from the Lymphoma Epidemiology of Outcomes (LEO) Consortium of Real-World Evidence (CReWE) cohort (1/1/2015–2/15/2023) were analyzed. Patients’ demographic and clinical characteristics were described and response rates, duration of response, progression-free survival, and overall survival were evaluated. Multivariable Cox proportional hazards regression models were used to assess associations between patient clinical characteristics and outcomes.</div></div><div><h3>Results</h3><div>The 2L+ cohort included patients treated with chemoimmunotherapy (N = 593), lenalidomide-based therapy (n = 60), polatuzumab vedotin-based therapy (N = 116), tafasitamab-based therapy (N = 55), and loncastuximab tesirine (N = 42). Most patients who received prior chimeric antigen receptor T-cell therapy (CAR-T) were refractory to the treatment. Across all patients, overall response rates were &lt;50%, with one-quarter achieving complete response and median duration of response and overall survival were short (&lt;6 and &lt;10 months, respectively) among patients treated with chemoimmunotherapy or novel therapies. The prognosis was worse for patients who had previously received CAR-T. Primary refractory status, high-risk disease, and failing 3 or more lines of therapy were significantly associated with worse outcomes.</div></div><div><h3>Conclusion</h3><div>Patients with r/r LBCL have unfavorable outcomes and need more effective treatment alternatives.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 4","pages":"Pages e183-e199.e8"},"PeriodicalIF":2.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}